What is vaginal vault prolapse after hysterectomy?
Vaginal vault prolapse is a condition that can occur after a hysterectomy, where the top (vault) of the vagina descends due to loss of support. It may cause vaginal bulging, pressure, or difficulties with bladder and bowel function.
Detailed Medical Explanation
After a hysterectomy, the top of the vagina (vault) is no longer anchored by the uterus and ligaments, making it susceptible to prolapse. This may be due to weakened connective tissues, ageing, or previous pelvic floor injury. Symptoms include a sensation of bulging, pelvic pressure, and sometimes difficulty with intercourse or urination. Treatment options include pelvic floor physiotherapy, pessaries, or surgery to restore support. (NHS: Pelvic organ prolapse)
Clinical Context
Vaginal vault prolapse is more likely in women who have had a hysterectomy, especially if other risk factors are present. Regular follow-up and early intervention are important to prevent worsening and improve quality of life.
Evidence-Based Approaches
NICE recommends conservative management first, with surgical repair options (such as sacrocolpopexy) for persistent or severe cases. Specialist assessment is essential. (NICE NG123)