The vagina is a muscular canal in the female reproductive system, extending from the vulva to the uterus. While often considered a single structure, it comprises distinct regions, each with specific roles. The vaginal vault is a component of this anatomy, important for overall pelvic health. This article defines the vaginal vault, clarifying its anatomical position, functions, and clinical importance.
Defining the Vaginal Vault
The vaginal vault is the uppermost part of the vagina. It forms a dome-like area at its internal end. In individuals with a uterus, this vault surrounds the cervix, which protrudes into this space. After a hysterectomy, the vaginal vault becomes the closed apex of the vagina.
Within the vaginal vault, several recesses are formed where the vaginal walls meet the cervix. These are known as the fornices, specifically the anterior, posterior, and two lateral fornices. The posterior fornix, located behind the cervix, is often deeper than the anterior fornix.
Its Anatomical Position
The vaginal vault is situated deep within the female pelvis. It is positioned inferior to the uterus and cervix when these organs are present. The vault lies posterior to the bladder and anterior to the rectum, with its precise location influenced by the surrounding pelvic organs.
The vault connects to surrounding structures, such as the uterosacral and cardinal ligaments, providing support within the pelvic cavity. These ligaments attach the upper vagina and cervix to the pelvic sidewalls and sacrum, contributing to the overall stability of the pelvic floor. This arrangement helps maintain the vault’s normal position relative to adjacent organs.
Key Functions of the Vaginal Vault
The vaginal vault contributes to several important physiological processes. It provides structural support for the organs situated above it, helping to maintain the integrity of the pelvic floor. This supportive role prevents the descent of pelvic organs.
The vault also plays a role in sexual activity, forming the upper part of the vaginal canal that accommodates intercourse. Its distensibility allows for changes in shape during arousal, contributing to vaginal changes during sexual activity. During childbirth, the vault’s capacity for significant distension and elasticity aids the passage of the baby through the birth canal.
Clinical Significance of the Vaginal Vault
The vaginal vault is important in medical contexts, especially following a hysterectomy. After a hysterectomy, the vault becomes the new, closed end of the vagina. This area often requires specific surgical attention to ensure proper suspension and reduce future complications.
The vaginal vault can also be susceptible to vaginal vault prolapse. This condition occurs when the top of the vagina descends or bulges into or even outside the vaginal opening. It commonly develops years after a hysterectomy, as uterus removal eliminates a key supportive structure for the upper vagina. Vaginal vault prolapse is a distinct form of pelvic organ prolapse, often accompanied by the weakening of other vaginal wall supports. The vaginal vault serves as an anatomical landmark during gynecological and pelvic surgeries, guiding surgeons in pelvic floor procedures.