Sacrospinous ligament colpopexy will be performed in a standard fashion. The approach is done by either entering the vagina along the anterior or posterior wall or at the apex. Approach and side of the suspension will be based on surgeon's preference. Prior to entry, the apex of the vaginal vault is first identified by visualizing the old hysterectomy scar. Allis clamps are used to demarcate the new vaginal apex and to ensure that this apex will suspend adequately to the sacrospinous ligament, which is identified transvaginally by palpation of the ischial spine. Once vaginal entry is made, sharp and blunt dissection are performed down to the pararectal space on one or both sides. Identification of the ischial spine confirms the position of the coccygeus-sacrospinous ligament complex. Once the complex is freed of any overlying areolar tissue, a Briesky Navratil retractor is placed to retract the rectum away from the site of suture placement and to help with visualization of the ligament complex.