Laparoscopic Vault Suspension to fix Vaginal Prolapse

Laparoscopic vault suspension is a procedure used to treat vaginal prolapse. Vaginal Prolapse is a condition in which the the innards of the vagina comes out of the body and hangs through the vaginal opening.


1st in Chennai


1 hr : 30 min

2

7

When a part of the body slips out of it’s original place, it is known as prolapse.

Due to weakening of the muscles that support the birth canal, there is a tendency for its walls to become lax and protrude into the canal. Because of this, the vagina comes out of the body and hangs like a tail. Often, the protrusion also involves part of the bowel (enterocele), bladder (cystocele) or rectum (rectocele).

how do you fix a prolapsed vagina

Structures called Uterosacral ligaments support the uterus and holds the uterus and vagina in place. When the muscles of the uterus weaken, these supporting structures detach, leading to prolapse. In such cases, a procedure called laparoscopic Vault Suspension is performed,  which pulls up the vaginal tissues and fixes it in place.

Most of the time, patients come in with a prolapse are elderly women who have already crossed their child bearing age. If the women undergoing this procedure no longer wishes to bear children, the womb is also removed (hysterectomy).

How is Laparoscopic vault suspension Performed

Two to three tiny incisions are made over the abdomen and special laparoscopic instruments are inserted.

The upper part of the vagina is pulled and attached to structures on the hip, which gives strong support to the vaginal muscle, and puts it back into place. The detached uterosacral ligaments are attached to the vaginal apex using sutures.

In severe cases of Vault Prolapse, along with the vaginal tissues, parts of the intestines, urinary bladder or rectum also protrude outside. In such cases, repair is done by pushing the involved organ back into the belly and suturing it in its original position.

Vaginal Prolapse and correction

Care After Laparoscopic vault suspension

For at least 4 weeks from surgery, patients will be advised to avoid heavy weight lifting, straining while passing stools, standing for long period of time, etc.

Treatment window

Vaginal prolapse is not life threatening. But if left untreated, it results in situations like uncontrolled urine leakage, pain during sexual intercourse, etc. Moreover, with time, the prolapse may also pull the uterus down. Once the uterus is involved, repair becomes difficult and one might need uterus removal surgery. Hence early treatment is always recommended.

Laparoscopic vault suspension FAQ

As the name indicates, this is a condition in which the vagina comes out of the body and hangs out like a tail.
The main reason for this is weakness of the pelvic floor. The ligaments (or the fibrous tissues) that hold the uterus and the vagina become weak, and the entire uterus and vagina fall floppily first toward the pelvis and then out of the pelvis all together.
Along with this, a portion of the bladder in front, or a portion of the rectum at the back can also push out. If the rectum pushes out, this is called a rectocele. If the bladder pushes out, it is called a cystocele.
Yes, one can have distressing symptoms in relation to the urinary tract if there is a cystocele and symptoms in relation to the rectum if there is a rectocele.
No, unfortunately there is no tablet, syrup, or injection that will make a prolapse go up. It is a mechanical problem, requiring a mechanical solution.
The solution usually is to remove the uterus through the vagina itself (Vaginal hysterectomy), and then repair the pelvic floor. This consists of repair in front if there is a cystocele (anterior repair) and a repair at the back if there is a rectocele (posterior repair).
Usually this happens in old patients wherein the fibrous tissues and the floor of the pelvis have become weak and therefore they do not need the uterus. Also, once a uterus is prolapsed, it is very difficult to reposition it. It makes sense to remove the uterus and repair the pelvic floor.
Yes. It can be done bloodlessly and painlessly. Indeed while performing these procedures, some cosmetic work can also be done.
These patients can actually have a tightening of the vagina known as Vaginoplasty. This serves as a great boost to the look and feel and especially satisfaction of these women.

Vault Suspension Specialists

Dr. Deepa Ganesh

Advance Laparoscopic Gynecologist, Robotic Surgeon & Cosmetic Gynecologist Surgeon

Dr. Jayalakshmi

Obstetrician and gynaecologist, Infertility specialist and Laparoscopic surgeon