It surprises many women that prolapse can still happen after a hysterectomy — without a uterus, what is there left to fall? What can still descend is the vaginal vault: the closed-off top of the vagina where the uterus used to attach, held up by the same ligaments and connective tissue that supported the uterus itself. If the hysterectomy was performed because of, or alongside, a prolapse, or if those supporting structures were already weakened by childbirth or chronic straining, that risk carries forward rather than disappearing with the surgery.
Vault prolapse tends to show up later than other types — sometimes years after the original operation — because it develops gradually as the same support structures continue to stretch under everyday pressure such as coughing, straining, heavy lifting, or the tissue changes of menopause. The sensation is similar to other forms of prolapse: heaviness, a bulge, or a feeling that something has "dropped," often more noticeable by the end of the day or after standing for long periods.
Ask whether you need to be seen
Message us with what you are experiencing and we will tell you whether an examination is worth making, and what the appointment involves.
WhatsAppLINEAssessment works the same way as for any prolapse: a physical examination while you bear down, since a vault that sits normally lying down can descend noticeably on standing or straining. This shows how far it has moved and whether the bladder or rectum are also involved, since vault prolapse often accompanies a cystocele or rectocele rather than occurring on its own.
Management options mirror other types of prolapse — pelvic floor muscle training for milder cases, a vaginal pessary as a non-surgical support option, or surgical repair for more advanced or bothersome cases, with the specific approach depending on whether this would be a first prolapse repair or a recurrence after the earlier hysterectomy. If you had a hysterectomy years ago and are now noticing heaviness or a bulge, that is worth assessing on its own terms rather than assuming it cannot be prolapse because the uterus is already gone.
THE FIT CLINIC is on the 8th Floor of EM Tower, EMSPHERE, 628 Sukhumvit Road, a short walk from BTS Phrom Phong, open daily 10:00 to 19:00. No referral is needed; book on LINE @thefitbkk, +66 92 294 6555, or bkkgyne@gmail.com. Consultations are in English or Thai, and an interpreter in another language can be arranged with advance notice if you ask on LINE when booking.