Surgery Overview
Vaginal vault prolapse occurs when the upper
portion of the vagina loses its normal shape and sags or drops down into the
vaginal canal or outside of the vagina. It may occur alone or along with
prolapse of the bladder (
cystocele ), urethra (
urethrocele ), rectum (
rectocele ), or
small bowel (
enterocele ).
Vaginal vault prolapse is usually caused by weakness of the pelvic and vaginal
tissues and muscles.
Symptoms of
vaginal vault prolapse include:
- Pelvic
heaviness.
- Backache.
- A mass bulging into the vaginal
canal or out of the vagina that may make standing and walking
difficult.
- Involuntary release of urine (
incontinence ).
- Vaginal bleeding.
During surgery, the top of the vagina is attached to the
lower abdominal (belly) wall, the lower back (lumbar) spine, or the
ligaments of the pelvis. Vaginal vault prolapse is
usually repaired through the vagina or an abdominal incision and may involve
use of either your tissue or artificial material.
-
Pelvic Organ Prolapse: Should I Have Surgery?
What To Expect After Surgery
General anesthesia is usually used for vaginal vault prolapse repair. You may
stay in the hospital from 1 to 2 days. You will probably be able to return to
your normal activities in about 6 weeks. Avoid strenuous activity for the first
6 weeks. And increase your activity level gradually.
Most women
are able to resume sexual intercourse in about 6 weeks.
Why It Is Done
Repair of a vaginal vault prolapse is
done to manage symptoms such as sagging or drooping of the top of the vagina
into the vaginal canal,
urinary incontinence , and painful intercourse.
Vaginal vault prolapse often occurs with other
pelvic organ prolapse . So tell your doctor about other
symptoms you may be having. If your doctor finds prolapse of other pelvic
organs during your pelvic exam, that problem may also be repaired
during surgery.
Your doctor may do an examination while you have a pessary in your vagina. This exam will help him or her see if urinary incontinence would be a problem after surgery. If the exam shows that urinary incontinence will be a problem, another surgery can be done at the same time to fix the problem.
How Well It Works
There are many surgical ways to fix a
vaginal vault prolapse. The kind of surgery you have will depend on the doctor
performing it, where you have it done, and your unique health situation.
Experts disagree about which surgery gives patients the best results.
footnote 1
Risks
Complications of surgery for vaginal vault
prolapse are uncommon but include:
- Bleeding.
- Mild buttock pain for 1
to 2 months following surgery.
- Urinary
incontinence.
- Urinary
retention.
- Infection.
- Formation of an abnormal opening
or connection between organs or body parts (
fistula ).
What To Think About
Surgical repair may relieve some,
but not all, of the problems caused by a vaginal vault prolapse. If pelvic
pain, low back pain, or pain with intercourse is present before surgery, the
pain may persist after surgery. Symptoms of urinary retention may return or get
worse following surgery.
You can control many of the activities
that may have contributed to your vaginal vault prolapse or made it worse.
After surgery:
- Avoid smoking.
- Stay at a healthy
weight for your height.
- Avoid constipation.
- Avoid
activities that put strain on the lower pelvic muscles, such as heavy lifting
or long periods of standing.
Complete the
surgery information form (PDF)
(What is a
PDF document?)
to help you prepare for this surgery.
References
Citations
-
Lentz GM (2012). Anatomic defects of the abdominal wall and pelvic floor. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 453-474. Philadelphia: Mosby Elsevier.
Credits
ByHealthwise Staff
Primary Medical Reviewer
Sarah Marshall, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
Specialist Medical Reviewer
Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
Current as ofDecember 7, 2017
Lentz GM (2012). Anatomic defects of the abdominal wall and pelvic floor. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 453-474. Philadelphia: Mosby Elsevier.
