A vaginal cuff is a closure a surgeon makes at the top of the vagina, near the typical location of the cervix. Surgeons usually perform this procedure as part of a total or radical hysterectomy.

Doctors recommend hysterectomies for females who would benefit from the surgical removal of the uterus. The cervix is the lowest part of the uterus, where it meets the vagina.

During a total or radical hysterectomy, a surgeon removes the whole uterus, including the cervix. The surgeon will then create a vaginal cuff in the place of the cervix.

Sometimes, a vaginal cuff procedure will be separate from a hysterectomy if this area needs repairing due to a tear or improper healing.

Female surgeon performing a vaginal cuff surgeryShare on Pinterest

Speaking with a doctor about the recovery process is essential, as everyone is different and may benefit from an individualized recovery plan.

Usually, a doctor will give the following instructions to someone who has just undergone a total hysterectomy:

  • getting plenty of bed rest for the first few weeks
  • not lifting heavy objects
  • avoiding straining during bowel movements
  • abstaining from sexual activity
  • not inserting anything other than prescribed medication into the vagina, including tampons

A doctor will also prescribe medications to prevent infections and reduce pain. A doctor may also recommend an estrogencream to apply to the vaginal cuff to help it heal.

Recovering from a hysterectomy with a vaginal cuff takes a minimum of 6–8 weeks but may take longer, depending on a person’s overall health.

While recovering from a hysterectomy with a vaginal cuff, an individual may need to consult a doctor for a checkup. The doctor will make sure the vaginal cuff is healing properly and check for signs of infection.

Ifscar tissueis forming on the vaginal cuff site, the doctor may apply a small amount of silver nitrate to burn off the scar tissue and aid healing.

Removing the scar tissue may be uncomfortable but should not be painful. This can usually take place in the doctor’s office without the need for a separate appointment.

While vaginal cuffs are generally safe, there is a small risk of the cuff tearing. A vaginal cuff tear occurs when the edges of the wound split or rip.

A vaginal cuff tear, also known as vaginal cuff dehiscence, is rare. Due to the suturing or cutting technique, people are more at risk for this complication if they have undergone a laparoscopic hysterectomy instead of an abdominal or vaginal hysterectomy.

If the vaginal cuff tear is very large, additional complications may occur, including a bowel evisceration. This happens when the bowels push through the torn vaginal cuff.

Factors that increase the risk of a vaginal tear after a hysterectomy include:

  • engaging in sexual activity before the vaginal cuff has healed
  • smoking cigarettes
  • unmanaged diabetes
  • obesity
  • history of radiation in the pelvic region
  • vaginal atrophy

While vaginal cuff tears are rare, they can be a life threatening medical emergency.

A person who is having a vaginal cuff as part of a hysterectomy should seek immediate medical attention if they develop any of the following symptoms:

While vaginal cuff tears are most likely to occur within a few days of the hysterectomy, they can occur at any time following the procedure.

Tears often occur spontaneously, but sexual activity or a bowel movement can also be a trigger.

A person will need surgery to repair the vaginal cuff if they experience a vaginal cuff tear. Other complications that require vaginal cuff repair include:

  • an abscess
  • peritonitis, which is inflammation of the lining of the abdomen and its organs
  • hematoma, which is a buildup of blood outside of the blood vessels
  • bowel evisceration

In some cases of a partial vaginal cuff tear, a surgeon can repair the cuff through the vagina instead of making an external incision.

Individuals will receive intravenous fluids and antibiotics before and after surgery. The length of the surgical procedure may vary based on what caused the tear or other complications.

After surgery, a person will go to a recovery room for monitoring while the anesthesia wears off. They may have to stay overnight in the hospital, particularly if bowel function is affected.

After a vaginal cuff repair, people need to allow 8–12 weeks of recovery time. During this time, a doctor will recommend avoiding any activity that strains the new incision, including heavy lifting and sex. Many doctors will also suggest getting lots of rest and limiting strenuous exercise.

The best way for individuals to manage a vaginal cuff is to follow the doctor’s instructions after a hysterectomy.

Some people may feel better in just a few weeks after surgery. They may push themselves too hard physically or have sex before the vaginal cuff has healed, accidentally causing an injury or tear.

A person healing from a hysterectomy and a vaginal cuff procedure should be gentle on their body and avoid physical and sexual activity until the cuff has fully healed.

Below are some commonly asked questions about a vaginal cuff.

What is a vaginal cuff?

A vaginal cuff is a closure made at the top of the vagina, near where the cervix is located. Typically, the procedure is part of a total or radical hysterectomy.

Does everyone get a cuff after a hysterectomy?

If a person is having a partial hysterectomy, also called a subtotal hysterectomy, the surgeon will not remove the cervix. In this case, a vaginal cuff is not necessary. However, during a total and radical hysterectomy, the surgeon removes the cervix, making a vaginal cuff necessary.

A vaginal cuff is a closure made at the top of the vagina, which is usually part of a total or radical hysterectomy.

Vaginal cuff tears and complications are rare, but it is important to take precautions. People can reduce their risk of experiencing these complications by following an individualized recovery plan after surgery and giving their bodies plenty of time to heal.

If a person needs a vaginal cuff repair, they will likely need to spend up to 12 weeks recovering before a doctor advises they can resume typical activities, including exercise and sexual activity.