Vaginal vault prolapse is a medical condition in women where the upper portion of the vagina becomes abnormal in shape and drops down into the canal of the vagina and sometimes sags outside the vagina.
It can occur by itself or along with the prolapse of the other organs, including the bladder, rectum, urethra, or the small bowel. Vaginal vault prolapse is caused by weakening vaginal tissue, pelvic tissue, and muscles. It is more common in women who have had a hysterectomy.
A woman with vaginal vault prolapse will experience the following symptoms:
• A heavy feeling in the pelvic region
• Back pain
• Bleeding in the vagina
• Incontinence (involuntary release of urine)
• Bulging or swelling in the vaginal canal or outside the vagina that makes sitting, standing, or walking difficult
Treatment Options for Vaginal Vault Prolapse
Undergoing a surgical procedure is the best treatment option for vaginal vault prolapse. Of the surgical techniques available, the laparoscopic sacral colpopexy is the ideal solution. During the sacral colpopexy technique, the abdomen is opened to give your surgeon the ability to perform the reconstruction.
Depending on the type of the vaginal vault prolapse and the extent of the problem, your surgeon will determine the best type of treatment to be used. Your surgeon will analyze the severity of your symptoms before determining whether or not the sacrocolpopexy technique will be the best option for your needs.
The Equipment Used During the Sacral Colpopexy Procedure
In addition to the basic equipment and instruments that come in an exploratory laparotomy set, the following additional equipment will be required to perform the sacral colpopexy technique:
• Vaginal instruments such as an end-to-end anastomotic sizer, a tenaculum, dilators, ring forceps, a weighted speculum, and breisky retractors
• A Bookwalter retractor
• Balfour
• Cystoscope
Your surgeon will use a graft to hold the vaginal wall and provide support for the suspension of the apical vault to the sacral promontory. It will involve using the following types of materials:
• Autologous fat transfer, a process that makes use of your own fat
• Using biological material taken from other animal or plant species – xenograft
• Synthetic material
The Procedure
Your surgeon will make a small keyhole incision in the abdominal area and using a laparoscope, he will suspend the uterus vault to the sacrum. The vaginal vault that has prolapsed because of the damage caused to the connective tissue that holds the vagina to the floor of the pelvis muscles will be suspended.
The surgeon uses a mix of soft materials, tissue and mesh materials to suture the vaginal wall and attach it back to the sacrum. The vagina will be moved back into position over the pelvic floor muscles and the newly formed meshwork will help keep it in place.
Contact Our Office
If you would like to learn more about treating vaginal vault prolapse, feel free to contact our office. Dr. John Miklos and Dr. Robert Moore will gladly discuss the details of the procedure and determine to correct course of action to help you find relief.