Postcoital Vaginal Vault Dehiscence 4 Months Post-Total Laparoscopic Hysterectomy

Background: As progress continues to be made in the movement from open abdominal procedures to minimally invasive options, total laparoscopic hysterectomy has continued to retain a preeminent position in the armamentarium of the practicing gynecologist. Case report: A 32 year old multiparous lady with persistent menstrual disorder and chronic pelvic pain despite conservative management, who underwent an uneventful total laparoscopic hysterectomy with a demonstrable healed vaginal vault on pelvic examination at 6 weeks and 3 months post surgery but later developed a 3cm rupture of the vaginal cuff on her first coital attempt 4months post-operation, which was repaired without complication using a delayed absorbable suture material. Conclusion: Despite the appearance of a well-healed vaginal vault, the possibility of rupture at first and subsequent coitus after a total laparoscopic hysterectomy should always be discussed pre-operatively.