Culdocele repair in female pelvic organ prolapse

Abstract Objectives To review patients with a culdocele, a wide and deep cul-de-sac, and to report the results of treatment by sacrocolpopexy. Methods A retrospective review of 117 patients with a culdocele identified by clinical examination and intraoperatively. Results The mean age and parity of the patients were 61.4 years and 3.1, respectively. Bladder complaints occurred in 46% of patients and bowel problems in 74% (mainly obstructed defecation). Something protruded through the vaginal introitus in 84% of patients. All patients were treated with a sacrocolpopexy: 96% with mobilization and elevation of the rectum (rectopexy), and 79% with Burch colposuspension. Follow-up results were obtained for 98% of the patients (mean, 14.7 months). Recurrent prolapse occurred in 10% of patients. Conclusions A culdocele differs from an enterocele because it a distended and deep cul-de-sac without a true hernia between the distal vagina and rectum. Sacrocolpopexy resulted in a 10% recurrence rate of prolapse.