Title

A 45 yo presents with symptomatic stage III pelvic organ prolapse. She has been using a pessary for 5 years, but now she would like surgery. She is an avid triathlete. She does not have any urinary or bowel symptoms. She is sexually active. Her apex and anterior vaginal wall are 5 cm outside the hymen. She wants the most durable repair with the fastest recovery time. What is the best surgery for her?