Sacrocolpopexy for vaginal vault prolapse changes the mechanical axis of the vagina and can result in prolapse of the anterior or posterior vaginal walls. Thirteen consecutive patients were examined before and after surgery using the POP-Q International Continence Society scoring system for genital prolapse. One patient had an intact cervix and therefore underwent sacrocervicopexy, whereas two patients had sacrohysteropexy. The other patients had sacrocolpopexy. Porcine small intestinal submucosal (SIS) absorbable mesh (Surgisis, Cook) was fixed to the posterior vaginal wall. The posterior wall remained well supported following SIS mesh interposition between the posterior vaginal wall and the rectum. Meshes can provide the much-needed support in pelvic reconstruction.