ObjectiveTo observe the functional and anatomic results in 50 patients undergoing abdominal sacrocolpopexy in the management of posthysterectomy vaginal vault prolapse.Study DesignIn 50 patients undergoing an abdominal sacrocolpopexy who had been followed for a median of greater than 5 years. A follow-up assessment reviewed their anatomic and functional status.ResultsIn 46 patients eligible for examination, a recurrent enterocele developed in 1 patient, and 2 patients experienced mesh-related morbidity. Durable vault support was afforted in 39 patients with 5 patients having minimal relaxation, which did not require therapy. Persistent urinary incontinence was noted in 5 patients.ConclusionSatisfactory long-term results can be obtained by the use of abdominal sacrocolpopexy in those patients in whom a vaginal procedure is less than satisfactory. Mesh-related complications are few. However, persistent urinary incontinence may be significant, albeit infrequent.