Post hysterectomy vault prolapse (PHVP) could happen in 0.2 to 43%. More recently, PHVP has been reported in 11.6% of hysterectomies performed for prolapse and 1.8% for other benign diseases. The frequency of PHVP requiring surgery is between 6–8%. The surgical repairs are effective, however, these are technically complex and are associated with substantial morbidity. Uterosacral and cardinal ligaments suspensions (ULS and CLS) during abdominal hysterectomy have been suggested to prevent PHVP. Round ligament suspension (RLS) of the vaginal vault during abdominal hysterectomy might be useful to prevent PHVP as an alternative/adjunct to ULS and CLS.
Bilateral round ligament