When is vaginal vault suspension performed?

Vaginal vault suspension is suitable for women who develop prolapse at the top of the vagina after hysterectomy (vaginal vault prolapse).

What does the operation involve?

Vaginal vault suspension, also called sacrospinous fixation, involves stitching the top of the vagina to the sacrospinous ligament, which is situated near the tail bone. The effect of this is to support the vagina, restoring it to its normal position and preventing it from prolapsing.

The operation is performed under a general or spinal (regional) anaesthetic through the vagina.

Sacrospinous vault fixation is probably slightly less successful at curing vaginal prolapse long term than sacrocolpopexy. We tend to recommend it when laparoscopic sacrocolpopexy is felt to be unsafe and a vaginal approach under epidural anesthesia is thought to be a better option.

Other repairs

Vaginal vault prolapse commonly exists together with prolapse at other sites, such as the front wall (cystocele) or the back wall of the vagina (rectocele). If there is a prolapse at any other site, the surgeon may suggest repairing this at the same time.

What is recovery after surgery like?

Patients are typically in hospital for 48 hours after surgery. Usually, on the first morning after the operation, the catheter is taken out and the drip removed. The patient is able to eat and drink and move around.

Recovery time varies from woman to woman. It is important to remember that everyone's experience is different, and it is therefore best not to compare one patient's recovery with that of others on the ward. The body will be using extra energy to build new cells and repair itself and patients may therefore feel tired for 4-6 weeks after surgery. Most women will resume driving and work within about 4 weeks.

Further information

For more information about recovering from the operation, and what to expect on going home, read our information leaflet: Sacrospinous fixation

External links:

Complete vaginal vault prolapse Sacrospinous vault suspension, showing the vaginal vault being stitched to the sacrospinous ligament