What is a Vaginal Vault Prolapse?

A vaginal vault prolapse is when the top of the vagina falls downwards, toward the opening of the vagina.

The vagina is a muscular tube providing a passage between the uterus and the outside of the body. It has three functions: admitting the penis during sexual intercourse, allowing menstrual blood to leave the body and giving birth.

A vaginal vault prolapse can only occur after a removal of the uterus (hysterectomy).

Symptoms of a vaginal vault prolapse include:
•    A mass protruding from your vagina
•    A feeling of pelvic heaviness
•    Painful intercourse

Less common symptoms include:
•    Difficulty passing urine (voiding)
•    Inability to fully empty your bladder
•    Urinary incontinence

What causes a Vaginal Vault Prolapse?

Your uterus provides support for the top part of your vagina. If your uterus is removed, your vagina is left unsupported and the top part may gradually fall toward the vaginal opening. Once the top part of the vagina has started to fall, the vaginal walls may further weaken, allowing your prolapse to become more severe.

Additionally, as a woman goes through menopause, estrogen levels fall. This leads to a weakening of the muscles surrounding the vagina, increasing the risk of prolapse. Eventually the top part of the vagina may fall far enough that it protrudes outside of the body.

Hysterectomy - the uterus has been removed, leaving the vagina unsupported.

Mild vaginal prolapse - a mild prolapse of the vagina, where the top of your vagina has started to drop downwards.

Severe vaginal prolapse - a more severe vaginal prolapse, where your vagina is protruding outside the body, pulling the bladder with it.

Vaginal vault prolapses are often seen with a prolapse of the small intestine (enterocele). Other prolapses that can be seen with vaginal vault prolapses include prolapse of the bladder (cystocele) and prolapse of the rectum (rectocele).

How is a Vaginal Vault Prolapse treated?

If your prolapse is not severe, a pessary can be used. A pessary is a device of various shapes and sizes that is placed in the vagina to support the vagina and pelvic organs to keep them in place. More severe vaginal vault prolapses require surgery to stabilize the vagina.

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