What Causes Vaginal Vault Prolapse?
- Family history and heredity play a part in vaginal vault prolapse
just as they do in many health conditions.
- Hysterectomy: During surgery to remove the uterus (hysterectomy), the strong supports
for the uterus (uterosacral ligaments) may be cut. Often times, the surgeon will re-connect
the ligaments in an effort to restore support and attach them to the top of the vagina that
is left. This type of repair, called a culdoplasty, may last for many years and provide support
for the top of the vagina. If support fails, the top of the vagina may prolapse (fall) into
the vagina or may even protrude outside of the vaginal opening.
- Aging and menopause which results in lower female hormone levels soften the tissues
that support the top of the vagina. This lack of normal support contributes to vaginal
vault prolapse.
- Multiple full term pregnancies and vaginal deliveries cause stress on the pelvic floor.
Over time, this effect may contribute to prolapse.
- Women with chronic constipation, chronic coughing or those who perform heavy lifting
also have a higher incidence of prolapse from the continual strain on the pelvic floor.
- Obesity, with the increased body mass pushing down on the pelvic floor causes increased
stress on pelvic muscles and support structures. Over time, this increased stress weakens
the pelvic floor and contributes to vaginal vault prolapse.
Many women have a combination of these factors that occur together to cause vaginal
vault prolapse. Because there are many contributing factors whose effects accumulate over
time, many women do not have symptoms until later in life, many years after hysterectomy
or child bearing.
