Iliococcygeus fixation for vaginal vault prolapse

Abstract

Attachment of the prolapsed vaginal vault to the iliococcygeus fascia was first described by Inmon in 1963 (Betschart et al. Neurourol Urodyn 2015). The iliococcygeus muscle is part of the levator ani complex which also includes the pubococcygeus and puborectalis muscles. It arises from the arcus tendineus of the levator ani and attaches posteriorly to the last two segments of the coccyx. The iliococcygeus can be approached from an anterior or posterior vaginal incision; therefore concomitant anterior or posterior repair is easily facilitated. Iliococcygeus fixation is an excellent method to suspend the vaginal vault, which maintains the vaginal vault axis and preserves vaginal length.