Treating Vaginal Vault Prolapse
Early stages of vaginal vault prolapse usually do not require surgery.
- Pelvic floor muscle training may be recommended.
- Locally applied estrogen in menopausal patients may help to restore tone to the vaginal mucosa.
- Pessaries are devices that are placed into the vagina to hold the top of the vagina in place.
For more advanced stages, there are surgeries other than the AVESTA® procedure
that can be performed to correct vaginal vault prolapse.
- Uterosacral ligament suspension performed vaginally - through an incision
at the top of the vagina, the uterosacral ligaments are identified and sutured
(stitched) together to re-establish support. This may be done at the time of
vaginal hysterectomy or after hysterectomy.
- Abdominal sacral colpopexy - through an abdominal incision, the top of
the vagina is sutured to the back of the pelvis to restore support and vaginal
length. This procedure requires advanced surgical skills, has a high rate of
success and a low need for repeat operations.
- Sacrospinous ligament fixation - a ligament from the back of the pelvic
floor is attached to the top of the vagina.
- Mesh techniques - other surgical techniques involve the placement of
polypropylene meshes that support vaginal tissues. These can be placed
through an abdominal incision, laparoscopically or through small incisions
in the buttocks.
- Obliterative procedure - for women who are no longer sexually active,
surgery to close the vaginal opening may be done.
