The vaginal cuff is the upper portion of the

vagina In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...

that opens up into the

peritoneum The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of meso ...

and is sutured shut after the removal of the cervix and

uterus The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The ...

during a hysterectomy. The vaginal cuff is created by suturing together the edges of the surgical site where the cervix was attached to the vagina. This is accomplished by bringing the edges of the vagina together and suturing them together and to the uterosacral ligaments to prevent prolapse. The peritoneum is also sewn into the newly created vaginal cuff. There may be an advantage to using one method of closure over another. The vaginal cuff has a tendency to partially or completely

dehisce Dehiscence is the splitting of a mature plant structure along a built-in line of weakness to release its contents. This is common among fruits, anthers and sporangia. Sometimes this involves the complete detachment of a part; structures that op ...

or open up. A further complication that can accompany the dehiscence of the vaginal cuff is evisceration or the movement of

intestines The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...

into the vagina. Some or all of the vaginal cuff can reopen. The risk of vaginal cuff complications is related to the approach to hysterectomy: robotic-assisted total

laparoscopic Laparoscopy () is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.Medlin ...

hysterectomy, total laparoscopic hysterectomy, laparoscopic-assisted vaginal hysterectomy, total abdominal hysterectomy, and total vaginal hysterectomy. The vaginal cuff can be stressed by sexual intercourse, chronic constipation,

asthma Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, co ...

COPD Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce ...

, and other actions that increase intra-abdominal pressure. This structure is prone to infection, hematoma and other postoperative complications. Factors that are thought to affect wound healing are radiation treatments, age,

pelvic organ prolapse Pelvic organ prolapse (POP) is characterized by descent of pelvic organs from their normal positions. In women, the condition usually occurs when the pelvic floor collapses after gynecological cancer treatment, childbirth or heavy lifting. In m ...

, the use of corticosteroids, concurrent malignancy. Though rare, estimates of the prevalence of vaginal cuff dehiscence are difficult to assess due to the presence of only case studies and anecdotal reports. If the vaginal cuff is compromised, vaginal evisceration can occur with the small intestine protruding out through the vagina.

References

{{reflist, 32em Vagina Gynaecology Women's health