What Happens If You Have A Tear In Your Vaginal Cuff

Current stats show that approximately 600,000 hysterectomies are performed yearly in the United States, making it one of the most common surgeries for women, per the National Woman's Health Network. According to a 2020 study published in the Journal of Family Medicine and Primary Care, one in three American women has undergone a hysterectomy by age 65. Indeed, the surgery is very common, possibly due to its effectiveness in treating various gynecological conditions, which include uterine fibroids, pelvic organ prolapse, and endometriosis.

If you've already had a hysterectomy, you're probably aware of the potential complications of such a major surgery. This is especially true concerning the vaginal cuff — the area where the vagina is stitched closed after the uterus is removed. The vaginal cuff is typically created by stitching the top edge of the vagina together, explains Medical News Today. However, sometimes a vaginal cuff tear, also known as vaginal cuff dehiscence, can happen. This is a rare but serious complication that can occur after a hysterectomy.

What causes a vaginal cuff tear?

A vaginal cuff tear happens when the stitches holding the vaginal cuff together separate. It can cause severe abdominal pain, discharge, and pressure in the pelvic area. Although rare, it happens in 0.14% to 4.1% of cases, per a 2014 article published via Pearls of Exxcellence. In these cases, surgical technique plays a role in the likelihood of a tear occurring. In other words, vaginal cuff tears are more common with minimally invasive procedures. The experts at Healthline add that total laparoscopic or robotic hysterectomies have greater risks of vaginal cuff tear than abdominal or vaginal hysterectomies. The type of sutures can also affect the closure.

Several other factors contribute to a vaginal cuff tear. Individual patient factors, such as smoking, having sexual intercourse, obesity, and constipation, can all influence the risk of a vaginal cuff tear. In fact, women with diabetes may have a slower healing process, which could increase the risk of complications.

How is a vaginal cuff tear treated?

Surgical intervention is necessary when a tear occurs. A transvaginal route, for example, is common when a slight tear is present without complications (via Healthline). On the other hand, laparoscopic or open abdominal surgery is needed if you have peritonitis, bowel evisceration abscess, or hematoma. You might also be given intravenous antibiotic therapy to prevent infections from occurring. 

Your doctor or surgeon may also want to monitor your recovery to prevent further complications. Therefore, attending all scheduled follow-up appointments is vital. Also, be sure to follow your doctor's instructions for postoperative care. This may include resting and avoiding activities that could strain the vaginal cuff, such as the lifting of heavy objects or sexual intercourse. With that said, recovery is usually around 8 to 12 weeks. After the surgery, if you experience any unusual symptoms, such as excessive bleeding, please get in touch with your doctor immediately.