A rare case of post coital vaginal vault dehiscence after 3 months of total laparoscopic hysterctomy

Vaginal Vault dehiscence after hysterectomy is a rare but a life-threatening condition. Vaginal evisceration of bowel can lead to intestinal ischemia and intraabdominal infection. Herein we report a case of 36 year old multiparous lady who underwent an uneventful total laparoscopic hysterectomy for fibroid uterus, with a demonstrable well healed vaginal vault at 6 weeks post surgery on pelvic examination, but later developed a 5 cm rupture of the vaginal cuff on her first coital attempt 3 months post-surgery, which was repaired without complication using a delayed absorbable suture material. 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.