Prolapse of the uterus (womb) and/or vaginal walls is a common condition, with up to 11% of women requiring surgery during their lifetime. Prolapse generally occurs due to damage to the supporting structures of the uterus or vagina. Weakening of the supports can occur during childbirth or as a result of chronic heavy lifting or straining, e.g., with constipation, chronic cough, obesity, and as part of the aging process. In some cases, there may be a genetic weakness of the supportive tissues. Prolapse of the uterus can cause an uncomfortable dragging sensation or feeling of fullness in the vagina. In more advanced prolapse, the cervix can extend beyond the entrance to the vagina.
What is a vaginal hysterectomy?
This is a procedure in which the uterus is surgically removed through the vagina. The operation is frequently combined with prolapse repairs of the bladder and/or bowel and sling procedures for urinary incontinence.
How is a vaginal hysterectomy performed?
The operation is under general or spinal anesthesia. A cut is made around the cervix. The surgeon then pushes the bowel and bladder away from the uterus. The blood vessels supplying the uterus and surrounding tissue are then clamped, cut, and tied. The surgeon then removes the uterus and closes the top of the vagina, now known as the vaginal vault. Many surgeons will choose to add additional support stitches.
Complications
With any operation, there is always a risk of complications:
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Complications due to anesthesia are very rare.
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Clots (embolism). After any pelvic surgery, clots can form in the legs or lungs. This is a rare complication that is minimized by using support stockings and blood-thinning agents.
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Severe blood loss and hematoma.
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Infections
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Injury to adjacent organs
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Urinary retention
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