ObjectiveTo review the results of the authors' technique for performing abdominal sacral colpopexy using polyester mesh in the treatment of women with posthysterectomy vaginal vault prolapse and enterocele.MethodsData were obtained from clinical examination, retrospective review of clinical records, and independent standardized telephone interview of patients who had undergone abdominal sacral colpopexy between 1991 and 1994 at Emory University Hospital in Atlanta, Georgia.ResultsA total of 49 patients underwent abdominal sacral colpopexy using polyester mesh. At the time of clinical review, one patient had died of a malignancy and one patient had moved without giving a forwarding address, leaving 47 patients available for interview. The mean follow-up time was 16 months (range, 2–36 months; median, 17 months). Physical examination revealed excellent support of the vaginal apex in all patients, and 85% of patients reported being satisfied with the results of their surgery. Patient dissatisfaction was related mainly to persistent urinary tract complaints after correction of vaginal prolapse. Sexual function was unchanged (30%) or improved (50%) in 80% of the sexually active women who underwent vaginal vault suspension.ConclusionsAbdominal sacral colpopexy with polyester mesh is an effective procedure for correcting posthysterectomy vaginal vault prolapse.