Vaginal vault prolapse is when the upper part of the vagina descends from its usual position, sometimes out through the vaginal opening. It is common after hysterectomy and can affect quality of life by causing pressure and discomfort, and by its effect on urinary, bowel and sexual function.
Treatment is rarely indicated if there are no symptoms. Mild-to-moderate prolapse may be treated with conservative measures such as pelvic floor muscle training, electrical stimulation and biofeedback. Topical oestrogens and mechanical measures such as pessaries may also be used. Surgery may be needed when the prolapse is severe. Different surgical procedures are available for repairing vaginal vault prolapse using vaginal or abdominal (open, laparoscopic or robotic) approaches. Some procedures involve using mesh to provide additional support.