Robotic sacrocolpopexy with medial umbilical ligament autologous graft to treat neovaginal prolapse in a transgender woman

Vaginoplasty is commonly performed to treat gender dysphoria in transgender women. Neovaginal prolapse is a late complication of vaginoplasty, and there is minimal literature regarding its surgical management. We report a case of robotic sacrocolpopexy using medial umbilical ligament autologous graft to treat neovaginal prolapse in a transgender woman, which is a novel technique that has not been previously described. The procedure resulted in a good postoperative outcome for the patient. The innovative use of medial umbilical ligament autologous graft enabled the patient to benefit from a fully minimally invasive procedure whilst avoiding the risks associated with synthetic mesh. • There is minimal evidence on surgery for neovaginal prolapse in transgender women. • The pelvic mesh scandal has led to the use of autologous fascia for sacrocolpopexy. • Medial umbilical ligament graft enables a minimally invasive procedure without mesh. • Robotic sacrocolpopexy with medial umbilical ligament graft appears to be effective.