Cooper ligament repair of vaginal vault prolapse twenty-eight years later.

Sir Astley P. Cooper, a British surgeon, first described Cooper's ligament in 1841; in 1949 this ligament was, to our knowledge, first used to support prolapse of the vaginal vault. The first preliminary report in 1965 was based on anatomical dissection of 60 autopsy cases and stressed mainly the length, thickness, width, and strength of the Cooper ligament strip and the adjacent fascia overlying the symphysis pubis. The preliminary report suggested that this was indeed a strong fascial support and would support the vaginal vault. Since 1965, some 85 cases have been treated and in each case, since 1965, every effort has been made to incorporate all of the available extra fascial planes in the pelvic structure to add further support to the vaginal vault prolapse. No major complications have been encountered. The risk of infection of Mersilene strips and synthetics is avoided by using homologous Cooper ligament strips and adjacent fascia. No postoperative stress incontinence was encountered in any of the 63 cases.