Repair of Vaginal Wall Prolapse (Vaginal Vault Prolapse)

Repair of Vaginal Wall Prolapse (Vaginal Vault Prolapse)

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.

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

  1. 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 StaffPrimary 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

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