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Post Hysterectomy Vaginal Vault Prolapse 

A vaginal vault prolapse occurs when the top of the vagina (the vault) falls toward the vaginal opening. A prolapse can be small, or incomplete, with only a little movement involved. It can also be complete, with the entire organ shifting and a portion of it protruding from the body.   

Causes of Post Hysterectomy Vaginal Vault Prolapse 

This condition occurs in up to 40% of women who have undergone a hysterectomy. Normally, the uterus supports the top of the vagina, so when the uterus is removed, that support is lost. Another factor is the gradual age-related weakening of the muscles and other tissues that support the vagina, making a prolapse more likely once the uterus is removed.  

Symptoms of Post Hysterectomy Vaginal Vault Prolapse 

Many patients don’t experience symptoms and only find out about their condition during an exam performed by a doctor.  

If symptoms develop, they can include: 

  • Pain and a feeling of fullness in the pelvic area 
  • Bulging inside the vagina 
  • Lower back pain 
  • Bladder infections 
  • Urinary incontinence 
  • Pain during sexual intercourse 
  • A portion of the vaginal vault protruding from the vagina (complete prolapse) 

Diagnosis of Post Hysterectomy Vaginal Vault Prolapse 

Proper diagnosis of this condition requires an in-office examination. Your healthcare provider will likely ask about any incontinence you’ve experienced as well as any pain or fullness in your pelvic area. If a vaginal vault prolapse is suspected, additional tests may be needed to rule out a bladder problem as the cause of the symptoms.  

Treatments for Post Hysterectomy Vaginal Vault Prolapse 

Treatment options will likely vary depending on the severity of the prolapse. Your treatment plan may also depend on factors such as your age, your sexual activity and your general health. Some nonsurgical treatment options include: 

  • Exercising the pelvic muscles 
  • Insertion of a vaginal pessary to provide support 

If surgery is deemed necessary, options include: 

  • Sacrocolpopexy – A piece of mesh is used to attach the vaginal vault to the tailbone. 
  • Vaginal vault suspension – The vagina is attached to ligaments inside the pelvis. 
  • Colpocliesis – The vagina is stitched shut to limit the chances of another prolapse. 

    Tampa General Hospital treats a variety of female urology problems, including post hysterectomy vaginal vault prolapse.