This is an updated guideline from RCOG on managing vaginal vault prolapse after hysterectomy. There isn't really anything new here, just confirmation of what we probably all do.
- Pelvic floor muscle training is useful for mild prolapse. The evidence here is for one-to-one training.
- Pessaries (both shelf and ring) are useful for all prolapse other than the very mild.
- Surgery isn't reserved for any specific degree of prolapse.