PURPOSE OF REVIEW: To review the etiology, presentation, imaging techniques and current surgical management of the apical @entity8218 . RECENT FINDINGS: Urologists are increasingly managing @entity322 and prolapse of the anterior and posterior compartment but most refer the management of the @entity661 to gynecologists. A variety of abdominal and vaginal repairs are commonly utilized to repair the @entity661 , often based on the surgeon's preference. Of the abdominal repairs, abdominal sacral colpopexy with mesh remains the gold standard. Laparoscopic techniques, although feasible, have not gained widespread acceptance. Of the vaginal restorative procedures there are proponents for uterosacral ligament vault suspension, iliococcygeus and sacrospinous ligament fixation. The uterosacral ligament vault suspension is the most anatomic of the repairs and hence least likely to create a predisposition to @entity1347 or compromise vaginal function. In rare instances where restorative procedures are discouraged and sexual function is no longer desired, obliterative procedures, which are better tolerated, may be more appropriate. SUMMARY: The best approach for restoration of vaginal apical support remains controversial with abdominal and vaginal routes commonly utilized. A single approach or procedure based on the surgeon's preference is not always optimal. Procedure selection should be individualized based on the @entity1 's age, comorbidities, prior surgical history and level of physical and sexual activity. The transvaginal uterosacral ligament vaginal vault suspension is increasingly our procedure of choice for management of the @entity661 due to its versatility, reduced postoperative morbidity and excellent short-term results.

Surgical management of the apical XXXX .

@entity1 :: ('9606', 'Species') :: ['patient'] @entity322 :: ('MESH:D014549', 'Disease') :: ['urinary incontinence'] @entity1347 :: ('MESH:C537775', 'Disease') :: ['future anterior or posterior vaginal wall defects'] @entity661 :: ('MESH:D054549', 'Disease') :: ['apical defect'] @entity8218 :: ('MESH:D014623', 'Disease') :: ['vaginal defect']
@entity8218 :: (MESH:D014623,Disease) :: ['vaginal defect']
