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Is Vaginal Cuff Dehiscence And Sutures Loosening Post A Hysterectomy Normal?

Posted on Wed, 6 Apr 2016

Question: 3 weeks ago I had total hysterectomy with bladder suspension....about 1 week after surgery I felt something in opening of vagina.....I took mirror and looked and vaginal cuff in resting at vaginal opening..also sutures in cuff have come loose..also having watery discharge....is this normal

Answered by Dr. Ramadevi Wani (25 minutes later)

Brief Answer:
Details below

Detailed Answer:
Hi,
Welcome to Healthcare Magic.
I am Dr Ramadevi Wani. I will be answering your concerns today.
As the vaginal cuff gets healed the sutures become loose and fall off. This is normal. Sometimes there can be watery discharge too during healing process. As long as it has no bad odour it is normal. So don't worry about it.
If the vaginal opening is wide one may see the vaginal cuff in the mirror. But if you are seeing and feeling the cuff at the vaginal opening it is not normal. It indicates weakness in the ligaments supporting the cuff. A clear assessment is possible by examination at 6 weeks post surgery.
I hope this is helpful.
If you have further concerns, do write to me. I will be happy to answer.
Best wishes
Dr Rama

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ramadevi Wani (1 hour later)

I can see and feel the cuff right at vaginal opening but it is not protruding out opening yet...tissue is completely covering vaginal opening....one of the reasons I had surgery was because of prolapsed bladder which was pushing wall out of vagina....do you suspect this is vaginal vault prolapse....I understand it's fairly common after hysterectomy....if so is surgery required to repair....thank you

Answered by Dr. Ramadevi Wani (15 hours later)

Brief Answer:
It is vault prolapse.

Detailed Answer:
Hi,
Welcome back.
Sorry for the delay in replying. Just got busy with hospital duties.

If you are feeling the vaginal cuff at the opening then it is vault prolapse. Yes it is fairly common after hysterectomy. The sutures binding the vaginal wall with ligaments may give way resulting in vault prolapse.
Vault prolapse of this degree needs surgery.
Try to replace the vaginal cuff back to its position and do the kegel exercises. This will help in strengthening the pelvic muscles. You can find the instructions for this exercise on the net.
If you have further queries do write to me I will be happy to answer.

Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramadevi Wani (26 hours later)

Thank you so much for all your information....you have been a big help in providing info to me....I promise these are my final 2 questions....if it is vault prolapse how soon after hysterecectomy can I have surgery to repair prolapse? Also I understand this repair is a little more challenging to fix....are most gynecologist capable of this surgery or should I see a ureogynecologist....more of a specialist....thanks again....God bless!!!!

Answered by Dr. Ramadevi Wani (2 hours later)

Brief Answer:
Details below

Detailed Answer:
Hi,
Welcome back.
I would suggest that you have the surgery for vault prolapse after another one month. It is good to wait for two months after hysterectomy for complete healing to take place. In the meantime keep doing the Kegel exercises.

Yes not all Gynecologists can do vault prolapse surgery. You need to ask and find out who is good at it. Some Urogynecologists also do this surgery. This surgery can be done laparoscopically too. Very few surgeons can do it laparoscopically.

If you have further concerns do write to me. I will be happy to answer.
Best wishes,
Dr Rama

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Naveen Kumar