What is vaginal vault prolapse?

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Vaginal vault prolapse: Overview

When the top of the vagina drops into the lower vagina or through the opening of the vagina, it is called vaginal vault prolapse.

This may happen after surgery to remove the uterus. This is because the uterus no longer supports the vagina.

This problem may cause you to leak urine or stool. Or you may have trouble passing urine or stool. You may feel pain during sex. Or you may feel pressure on your genitals.

Medicine may help you feel better. You can also talk to your doctor about a device you put in your vagina (vaginal pessary). It may help with symptoms. Surgery may also be an option.

Vaginal vault prolapse

Vaginal vault prolapse is when the top of the vagina drops near or through the opening of the vagina. It 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 if you've had a previous prolapse. When the top of the vagina loses the support of the uterus, it can drop into the vaginal canal.

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

How can you care for a vaginal vault prolapse?

  • Do not do activities that put pressure on your pelvic muscles. This includes heavy lifting and straining.
  • Try exercises to tighten and strengthen your pelvic muscles. These are called Kegel exercises. (If doing these exercises causes pain, stop doing them and talk with your doctor.) To do them:
    • Squeeze your muscles as if you were trying not to pass gas. Or squeeze your muscles as if you were stopping the flow of urine. Your belly, legs, and buttocks shouldn't move.
    • Hold the squeeze for 3 seconds, then relax for 5 to 10 seconds.
    • Start with 3 seconds, then add 1 second each week until you are able to squeeze for 10 seconds.
    • Repeat the exercise 10 times a session. Do 3 to 8 sessions a day.
  • Talk with your doctor about a vaginal pessary. This is a device that you put in your vagina to support it. Your doctor can teach you how and when to remove it. You will also learn how to clean it and put it back in.
  • If your doctor prescribes estrogen cream for your vagina, use it exactly as prescribed.
  • To relieve pressure on your vagina, lie down and put a pillow under your knees. Or you can lie on your side and bring your knees up to your chest.
  • If you are overweight, talk to your doctor about safe ways to lose weight.

Vaginal vault prolapse

Vaginal vault prolapse.

Vaginal vault prolapse is usually caused by weakness of the pelvic and vaginal tissues and muscles. It can also occur following the surgical removal of the uterus (hysterectomy), especially if you've had a previous prolapse.

(The first picture shows where the uterus was before it was removed.) When the top of the vagina loses the support of the uterus, it can drop into the vaginal canal.

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