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Topic: Vaginal vault prolapse

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	Vaginal Vault Prolapse
		Vaginal vault prolapse can occur after any type of hysterectomy - abdominal, vaginal, or laparoscopic.
		The top of the vagina (vaginal vault), if left unsupported, may fall down (prolapse) into the vaginal opening or even to the point of protruding outside of the body.
		Other studies state that vaginal vault prolapse occurs in about 2-3% of women but that it is increasing with the aging U.S. population.
	www.inletmedical.org /vaginal_vault_prolapse.asp (126 words)

	Vaginal Prolapse - womenshealthchannel
		Vaginal prolapse, also called pelvic organ prolapse, occurs when an organ in the pelvis (e.g., uterus, urethra, bladder) or the top portion of the vagina (called the vaginal vault) drops down into or protrudes through (herniates) the vagina.
		Vaginal prolapse can occur when this support system weakens or is damaged.
		Following removal of the uterus (hysterectomy), the upper portion of the vagina (vaginal vault) may drop toward the vaginal opening.
	www.womenshealthchannel.com /vaginalprolapse (552 words)

	Repair of the vaginal wall (vaginal vault prolapse)
		Vaginal vault prolapse occurs when the upper portion of the vagina loses its normal shape and sags or bulges down into the vaginal canal or outside of the vagina.
		Vaginal vault prolapse is usually repaired through the vagina or an abdominal incision and may involve use of either your tissue or artificial material.
		Repair of a vaginal vault prolapse is done to manage symptoms such as bulging of the vaginal wall into or outside of the vagina, urinary incontinence, and painful intercourse.
	women.webmd.com /Women-Medical-Reference/Repair-of-the-vaginal-wall-vaginal-vault-prolapse (603 words)

	Repair of the vaginal wall (vaginal vault prolapse)
		Vaginal vault prolapse occurs when the upper portion of the vagina loses its normal shape and sags or bulges down into the vaginal canal or outside of the vagina.
		Vaginal vault prolapse is usually repaired through the vagina or an abdominal incision and may involve use of either your tissue or artificial material.
		Repair of a vaginal vault prolapse is done to manage symptoms such as bulging of the vaginal wall into or outside of the vagina, urinary incontinence, and painful intercourse.
	www.webmd.com /hw/womens_conditions/tv1559.asp (482 words)

	Vaginal Prolapse
		A vaginal prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, out of their normal positions.
		Prolapsed uterus (womb) - This involves a weakening of a group of ligaments called the uterosacral ligaments at the top of the vagina.
		Third-degree prolapse: The cervix, which is located at the bottom of the uterus, sags to the vaginal opening and may protrude outside the body.
	www.emedicinehealth.com /vaginal_prolapse/article_em.htm (676 words)

	Mesh sacrocolpopexy for vaginal vault prolapse: consultation
		Current evidence on the safety and efficacy of mesh sacrocolpopexy for vaginal vault prolapse appears adequate to support the use of this procedure provided that the normal arrangements are in place for consent, audit and clinical governance.
		Vaginal vault prolapse occurs when organs of the pelvis descend from their normal positions towards or through the vaginal introitus.
		In a randomised controlled trial comparing abdominal sacrocolpopexy with vaginal sacrospinous colpopexy, de novo dyspareunia and urinary incontinence were reported in 11% (2/19) and 9% (2/22) of women, respectively, after abdominal surgery (p value not reported) and in 18% (3/17) and 33% (8/24) of women, respectively, after vaginal surgery (p =0.09).
	www.nice.org.uk /page.aspx?o=ip311consultation (1290 words)

	eMedicine - Enterocele and Massive Vaginal Eversion : Article by Rony A Adam, MD
		Massive vaginal vault prolapse (uterovaginal prolapse) is a devastating condition with discomfort and genitourinary and defecatory abnormalities as the primary consequences.
		Vaginal vault prolapse is thought to occur postoperatively in 0.5% of hysterectomy cases, whether they are performed vaginally or abdominally.
		Vaginally excising the eroded mesh as deep as is safely accessible, undermining and freshening the edges of the involved vagina, and closing it primarily with delayed absorbable sutures generally is preferable.
	www.emedicine.com /med/topic3323.htm (7788 words)

	eMedicine - Enterocele and Massive Vaginal Eversion : Article Excerpt by: Rony A Adam, MD
		Massive vaginal vault prolapse (uterovaginal prolapse) is a devastating condition with discomfort and genitourinary and defecatory abnormalities as the primary consequences.
		Apical prolapse is used to denote prolapse of the vaginal apex with or without the presence of a uterus.
		Prolapse of the vaginal apex may or may not be accompanied by an enterocele.
	emedicine.com /med/byname/enterocele-and-massive-vaginal-eversion.htm (697 words)

	Laparoscopic Procedure, Vaginal Vault Suspension, Urogynecology, Gynecology
		Vaginal vault prolapse occurs when the apex of the vagina (upper 1/3 of the vagina) has broken away from its original support structure known as the uterosacral ligament.
		In an attempt at preventing future vaginal apex or vault prolapse, the uterosacral ligament should be attached to the apex of the vagina after the uterus has been removed.
		Likewise, if the patient has uterovaginal prolapse and has a hysterectomy without regard to precise closure of the vaginal cuff (ie the area where the uterus is detached from the vagina), she may end up with an enterocele and a vaginal vault prolapse (Figure 4).
	www.tvtsling.com /lap_proc7.php (707 words)

	Scientific Publications on Pelvic Organ Prolapse
		Pelvic organ prolapse including uterine and vaginal vault prolapse are major health concerns affecting large numbers of women.
		High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse.
		McKinney TB., Rogers R., Shraga J. Laparoscopic vaginal vault suspension utilizing the uterosacral ligament fixation for uterine and vaginal vault prolapse
	www.inletmedical.com /prolapse_publications.asp (503 words)

	Robot-assisted surgery shows a better way for vaginal vault prolapse --- HealthandAge
		Vaginal vault prolapse is a common complication after a hysterectomy.
		For the ten per cent of women affected with vaginal vault prolapse after hysterectomy, the problem is both socially embarrassing and physically incapacitating.
		At present, robot-assisted vaginal vault repair is limited in its availability because few surgeons have the training or equipment.
	www.healthandage.com /public/health-center/29/news/8746/Robot-assisted-surgery-shows-a-better-way-for-vaginal-vault.html (257 words)

	Robotic-Assisted Laparoscopic Sacrocolpopexy to Treat Vaginal Vault Prolapse (Site not responding. Last check: 2007-10-16)
		Vaginal vault prolapse is common after hysterectomy because the uterus acts as an anchor for the vagina.
		The goal of this approach is 3-fold 1) to minimize morbidity, 2) to increase the strength and durability of a minimally invasive vault prolapse repair, 3) to maintain the surgical principles and benefits of the open abdominal technique.
		The etiology of vaginal vault prolapse includes hysterectomy, multiple childbirths, age, chronic cough and asthma that may result in recurrent application of pressure on the vagina and its support structures.
	www.mayoclinic.org /clinical-update/20-2-vaginalprolapse.html (933 words)

	Pelvic Organ Prolapse
		Prolapse may also be called uterine prolapse, genital prolapse, uterovaginal prolapse, pelvic relaxation, pelvic floor dysfunction, urogenital prolapse or vaginal wall prolapse.
		There are a number of different types of prolapse that can occur in a woman's pelvic area and these are divided into three categories according to the part of the vagina they affect: front wall, back wall or top of the vagina.
		Vault prolapse occurs in about 15% of women who have had a hysterectomy for uterine prolapse, and in about 1% of women who have had a hysterectomy for other reasons.
	www.womenshealthlondon.org.uk /leaflets/prolapse/prolapse.html (737 words)

	eMedicine - Uterine Prolapse : Article Excerpt by: Thomas Mailhot, MD
		Anatomically, the vaginal vault has 3 compartments: an anterior compartment (consisting of the anterior vaginal wall), a middle compartment (cervix), and a posterior compartment (posterior vaginal wall).
		The process of vaginal childbirth results in stretching of the pelvic floor, and this appears to be the most significant cause of uterine prolapse.
		In neonates, uterine prolapse is secondary to congenital weakness in the pelvic musculature or to defects in innervation.
	www.emedicine.com /emerg/byname/uterine-prolapse.htm (444 words)

	Genital prolapse
		A first degree prolapse occurs when the organ has descended a short distance into the vagina, a second degree when it has descended far enough to reach the vaginal opening and a third degree when it is protruding through the vaginal opening.
		Prolapse occurs due to a weakness or damage that has occurred to the structures which hold the pelvic organs in place.
		The most appropriate treatment will depend upon the type of prolapse or prolapses, their severity, the age of the woman, her state of health and whether she wishes to have a child or further children.
	www.womhealth.org.au /factsheets/genital_prolapse.htm (2792 words)

	prolapse (Site not responding. Last check: 2007-10-16)
		STUDY DESIGN: Fifty women with uterine or vaginal vault prolapse with descent of the cervix or the vaginal vault to the introitus or greater were treated between 1993 and 1996 by the same surgeon with bilateral uterosacral ligament fixation to the vaginal cuff by the vaginal route.
		Patients with vault prolapse underwent posterior vaginal repair, obliteration of the enterocele sac and sacrospinous colpopexy.
		The vaginal vault prolapse was grade II and III in 4 and 6 patients, respectively.
	www.up.ac.za /asservices/ais/med/prolapse.htm (9196 words)

	Urogynecology, Vagina Plastic & Cosmetic Surgery, gynecology, tvt
		Vaginal vault prolapse occurs when the apex of the vagina (upper 1/3 of the vagina) has broken away from its original support structure known as the uterosacral ligament.
		In an attempt at preventing future vaginal apex or vault prolapse, the uterosacral ligament should be attached to the apex of the vagina after the uterus has been removed.
		Likewise, if the patient has uterovaginal prolapse and has a hysterectomy without regard to precise closure of the vaginal cuff (ie the area where the uterus is detached from the vagina), she may end up with an enterocele and a vaginal vault prolapse (Figure 4).
	tvtsling.com /lap_proc7.php (669 words)

	Pelvic organ prolapse
		A vaginal pessary is a small device, similar to a diaphragm or cervical cap, which is inserted into the vagina to hold the prolapsed organ(s) in place.
		The choice of surgery depends on the type of prolapse you have, your health, age, whether you want to keep your uterus or have children in the future, whether you are sexually active, the skills of your surgeon and your personal preference.
		This procedure is used to treat prolapse of the bladder (cystocele), urethra (urethrocele) or both the bladder and urethra (cystourethrocele).
	www.womenshealthlondon.org.uk /leaflets/prolapse/prolprint.html (7204 words)

	Femalepatient.com
		The vaginal approach to pelvic reconstruction has the advantage of access to all three segments of prolapse, the anterior and posterior vagina and the apex, as well as the ability to perform procedures for stress urinary incontinence that commonly coexists with prolapse, via the same approach.
		Vaginal repair of uterine or vaginal vault prolapse requires resuspension of the vaginal apex to ligamentous or connective tissue supports in the pelvis.
		Vaginal surgery is often preferred for obese patients based on the premise that vaginal surgery results in less morbidity, but recent gynecologic and general surgery literature does not necessarily support this.
	www.femalepatient.com /html/arc/sig/advan/articles/029_08_032.asp (3120 words)

	Vaginal vault prolapse
		Vaginal vault prolapse is a type of pelvic organ prolapse that can occur following surgical removal of the uterus (hysterectomy).
		The amount of the drop in a vaginal vault prolapse can vary from a slight sag into the vaginal canal to a complete drop, where the top of the vagina bulges outside of the vaginal opening.
		Vaginal vault prolapse may be treated with a special device that holds the vagina in place (vaginal pessary).
	www.webmd.com /hw/health_guide_atoz/stv8860.asp (195 words)

	Vaginal Vault Prolapse
		Vaginal vault prolapse can occur after any type of hysterectomy - abdominal, vaginal, or laparoscopic.
		The top of the vagina (vaginal vault), if left unsupported, may fall down (prolapse) into the vaginal opening or even to the point of protruding outside of the body.
		Other studies state that vaginal vault prolapse occurs in about 2-3% of women but that it is increasing with the aging U.S. population.
	www.dyspareunia.com /vaginal_vault_prolapse.asp (126 words)

	Pelvic Organ Prolapse - Menopause
		Pelvic organ prolapse is a condition in which the uterus and/or the vaginal walls drop down and some times through the vaginal opening.
		Prolapse occurs when the support structures to the uterus and vagina are damaged.
		An enterocele and vaginal vault prolapse usually present with a notable bulge in the vagina, pelvic pressure and pain, and problems with intercourse.
	www.bellaonline.com /articles/art44811.asp (643 words)

	Técnicas Cirúrgicas - Vol. 3
		The vaginal approach to vaginal vault prolapse is the sacrospinous fixation.
		Since vaginal vault prolapse increases in incidence with aging, it is not uncommon to find a delicate elderly woman presenting with symptomatic vaginal vault prolapse.
		Vaginal vault prolapse is a rather commonly occurring type of vaginal "hernia".
	www.jinuf.org.br /volume3/artigos/ing/002/tcir.htm (1266 words)

	Treating Vaginal Vault Prolapse
		Early stages of vaginal vault prolapse usually do not require surgery.
		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.
	www.dyspareunia.org /vaginal_vault_prolapse_treatment.asp (233 words)

	Treatment Options
		If a woman develops symptoms of one type of vaginal prolapse, she is likely to have or develop other types as well.
		Vaginal vault prolapse and herniated small bowel (enterocele) These defects often occur together high in the vagina, so surgery may be approached through the vagina or abdomen (for severe vaginal vault prolapse).
		This usually involves vaginal vault suspension, in which the surgeon attaches the vagina to the tailbone at the base of the spine.
	www.mayoclinic.org /pelvic-organ-prolapse/treatment.html (706 words)

	Vaginal Prolapse Relaxation - J. Miklos, MD
		A simple analogy to the vaginal wall, skin and peripheral attachment is the floor you may be standing upon.
		Continued uterine and vaginal prolapse can result in a complete uterine and vaginal prolapse such that the uterus falls outside the vaginal opening and the vagina falls inside out.
		Vaginal vault prolapse usually refers to an apical vaginal relaxation in an individual who no longer has a uterus (post hysterectomy).
	www.obgyn.net /urogyn/articles/miklos-vagprolapse.htm (1211 words)

	JRM Aug1999: True Incidence of Vaginal Vault Prolapse: Thirteen Years of Experience (Site not responding. Last check: 2007-10-16)
		Using the modalities in the literature, the incidence of vault prolapse was 0.4%.
		Therefore, the incidence of vaginal vault prolapse was 11.6% (14/120 patients) when hysterectomy had been performed for genital prolapse and 1.8% (6/328) when hysterectomy had been performed for other benign diseases.
		In the latter group (328 patients), all the cases of vault prolapse developed after abdominal hysterectomy: the incidence was 2% (6/308 patients); no case (0/20 patients) of vault prolapse developed after vaginal hysterectomy that had been performed on patients without genital prolapse.
	www.jreprodmed.com /abs/jrm718.htm (381 words)

	Women's Health > Laparoscopic Surgery for Vaginal Vault Prolapse Found To Be Effective
		Mayo Clinic researchers have found that laparoscopic surgery assisted by a surgical robot to fix vaginal vault prolapse, a collapse of the vagina that can occur after a hysterectomy, is an effective option to the traditional, open surgical repair when measured at least a year after the surgery.
		To conduct this study, the researchers followed 30 patients undergoing robotic-assisted laparoscopic repair for post-hysterectomy vaginal vault prolapse.
		One patient experienced recurrence of her vaginal vault prolapse, and another developed a recurrent grade 3 rectocele, in which the rectum protrudes into the vagina.
	www.emaxhealth.com /4/6710.html (624 words)

	DARE abstract20040298 (Site not responding. Last check: 2007-10-16)
		The use of abdominal sacral colpopexy and vaginal sacrospinous colpopexy in the treatment of vaginal vault prolapse.
		The objective of the study was to assess the clinical implications of abdominal sacral colpopexy versus vaginal sacrospinous colpopexy in the treatment of vaginal vault prolapse.
		Women with symptomatic posthysterectomy vaginal vault prolapse that extended to or beyond the introitus were included in the study.
	nhscrd.york.ac.uk /online/nhseed/20040298.htm (1577 words)

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