A 65-year-old woman who underwent total abdominal hysterectomy 5 years ago now presents with a bulge at the vaginal introitus. On examination, the vaginal vault is protruding 2 cm beyond the hymen. The diagnosis is:

• A Cystocele
• B Uterine prolapse
• C Enterocele
• D Vault prolapse ✓

Explanation

Vault prolapse is descent of the vaginal cuff after hysterectomy. It is staged using the POP-Q system similarly to other prolapses. Uterine prolapse cannot occur after hysterectomy. Cystocele is anterior wall prolapse. Enterocele is herniation of the pouch of Douglas through the upper posterior wall, which may coexist but the primary finding here is vault descent.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.