ObjectiveThe purpose of this study was to assess the results of the sacrospinous ligament fixation for the treatment of vaginal vault prolapse after hysterectomy.DesignBetween 1979 and 1996, 63 women underwent a reconstructive operation because of vaginal prolapse after abdominal or vaginal hysterectomy. Sacrospinous ligament fixation was performed in all women in combination with operative correction of either cystocele or rectocele, or both.ResultsRecurrent vaginal prolapse occurred in only one woman 3 years after the operation. Temporary nerve damage was observed in two patients. Six women reported urine loss because of stress incontinence after sacrospinous ligament fixation.ConclusionVaginal vault suspension to the sacrospinous ligament avoids major abdominal surgery and allows the surgeon to correct coexistent cystocele and rectocele. Sacrospinous ligament fixation of the prolapsed vaginal vault should be performed with colposuspension if masked urinary stress incontinence is preoperatively detected.