Objectives: A prospective study was conducted to assess the efficacy of sacrospinous vaginal vault fixation and its impact on the anterior compartment. The Pelvic Organ Prolapse Quantification (POP-Q) system was used to quantify pelvic organ prolapse in the apical and anterior vaginal compartments. Methods: Fifty-eight patients underwent a procedure to correct apical prolapse from March 2003 to February 2006. Mean preoperative and postoperative POP-Q scores were respectively: Aa (+0.74; -1.45); Ba (+3.17; -1.36); C (+3.41; -7.71) (p<0.001). Results: Cure rate was 93.1%. Preoperative and postoperative evaluation of the anterior vaginal compartment was respectively: stage 1 (5.2%; 48.3%), stage 2 (6.9%; 34.5%), stage 3 (74.1%; 5.2%), and stage 4 (13.8%; 0%). De novo cystocele occurred in 87.9% of cases. An improvement was seen in lower urinary tract symptoms of urgency, nocturia, and urge incontinence. Conclusions: Sacrospinous vaginal vault suspension is effective for the treatment of apical prolapse and leads to formation of cystocele in most cases. © 2010 Asociación Española de Urología (AEU).341106110Weber, A.M., Abrams, P., Brubaker, L., Cundiff, G., Davis, G., Dmochowski, R., The standardization of terminology for researchers in female pelvic floor disorders (2001) Int Urogynecol J, 12, pp. 178-186DeLancey, J.O.L., Anatomic aspects of vaginal eversion after hysterectomy (1992) Am J Obstet Gynecol, 166, pp. 1717-1728Mant, J., Painter, R., Vessey, M., Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study (1997) Br J Obstet Gynaecol, 104, pp. 579-585Richer, K., Massive eversion of the vagina: pathogenesis, diagnosis and therapy of the "true" prolapse of the vagina stump (1982) Clin Obstet Gynecol, 25, pp. 897-899Maher, C., Baessler, K., Glazener, C.M.A., Adams, E.J., Hagen, S., Surgical management of pelvic organ prolapse in women (2005) Cochrane Database Syst RevRandall, C.L., Nichols, D.H., Surgical treatment of vaginal eversion (1971) Obstet Gynecol, 38, pp. 327-332Nichols, D.H., Sacrospinous fixation for massive eversion of the vagina (1982) Am J Obstet Gynecol, 142, pp. 901-904Cruikshank, S.H., Cox, D.W., Sacrospinous Fixation at the Time of Transvaginal Hysterectomy (1990) Am J Obstet Gynecol, 162, pp. 1611-1619Sze, E.H.M., Karram, M.M., Transvaginal repair of vault prolapse: a review (1997) Obstet Gynecol, 89, pp. 466-475Lovatsis, D., Drutz, H.P., Safety and efficacy of sacrospinous vault suspension (2002) Int Urogynecol J, 13, pp. 308-313Shull, B.L., Capen, C.V., Riggs, M.W., Kuehl, T.J., Preoperative and postoperative analysis of site-specific pelvic support defects in 81 women treated with sacrospinous ligament suspension and pelvic reconstruction (1992) Am J Obstet Gynecol, 166, pp. 1764-1771Carey, M.P., Slack, M.C., Transvaginal sacrospinous colpopexy for vault and marked uterovaginal prolapse (1994) Br J Obstet Gynaecol, 101, pp. 536-540Holley, R.L., Varner, R.E., Gleason, B.P., Apffel, La., Scott, S., Recurrent pelvic support defects after sacrospinous ligament fixation for vaginal vault prolapse (1995) J Am Coll Surg, 180, pp. 444-448Paraiso, M.F.R., Ballard, L.A., Walters, M.D., Lee, J.C., Mitchinson, A.R., Pelvic support defects and visceral and sexual function in women treated with sacrospinous ligament suspension and pelvic reconstruction (1996) Am J Obstet Gynecol, 175, pp. 1423-1431Bump, R.C., Mattiasson, A., Bo, K., Brubaker, L.P., DeLancey, J.O.L., Klarskov, P., The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction (1996) Am J Obstet Gynecol, 175, pp. 10-17DeLancey, J.O., Morgan, D.M., Fenner, D.E., Kearney, R., Guire, K., Miller, J.M., Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse (2007) Obstet Gynecol, 109, pp. 295-302Petros, P.E., Ulmsten, U., The posterior fornix syndrome: a multiple symptom complex of pelvic pain and abnormal urinary symptoms deriving from laxity in the posterior fornix of the vagina. An integral theory and its method for the diagnosis and management of female urinary incontinence (1993) Scand J Urol Nephrol, (SUPPL. 153), pp. 89-93Petros, P.E., New ambulatory surgical methods using an anatomical classification of urinay dysfunction improve stress urge and abnormal emptying (1997) Int Urogynecol J, 8, pp. 270-278