The aging of our population has resulted in a greater number of women presenting with symptomatic vaginal vault prolapse. Recent population surveys have demonstrated that 11.1- 29.2 % of adult woman may require surgery and re-operation for vaginal prolapse3. Typically, women with vaginal vault prolapse will present with an exteriorized vaginal mass (fig.1).  In planning reconstructive surgery, accurate localization of the vaginal apex is crucial in achieving satisfactory restoration of normal anatomy.
Care must be taken to not confuse vaginal vault prolapse with an anterior vaginal prolapse (cystocele) or posterior support weakness (rectocele). Vaginal vault prolapse typically occurs concomitantly with a posterior vaginal enterocele. Although correction of anterior, posterior, uterine and vault defects is described separately, the surgeon should not consider these procedures in isolation; rather, they should be performed together in patients to establish functional unity of the pelvic organs7,8,9.