Vaginal vault prolapse is usually caused by weakness of the muscles and tissues in the pelvis or vagina. It can occur following surgical removal of the uterus (hysterectomy), especially in women with a previous prolapse. When the top of the vagina loses the support of the uterus, it often sags or drops into the vaginal canal.

The amount of the drop in a vaginal vault prolapse can vary from a slight sag into the vaginal canal to a complete drop, where the top of the vagina bulges outside of the vaginal opening.

Most women with a vaginal vault prolapse will also have bulging of the small bowel (enterocele) into the vagina. Other bladder and bowel problems, such as urinary incontinence and constipation, are likely to occur with vaginal vault prolapse.

Vaginal vault prolapse may be treated with a special device that holds the vagina in place (vaginal pessary). Surgery sometimes is needed to repair vaginal vault prolapse.