Uterine prolapse surgery is a procedure performed to correct uterine prolapse, in which the uterus falls out of position. In some cases, it protrudes into the vagina, and in severe prolapse, the uterus and vagina may both protrude from the body. Instability of other organs that rely on the pelvic floor for support can occur at the same time. Surgery is not necessarily the first line of treatment, and it may not be recommended for all patients.
Surgeons performing uterine prolapse surgery can enter through the vagina or the abdomen. In many procedures, the uterus is simply removed with a hysterectomy and donor tissue from the patient's body is used to support the pelvic floor. This will reduce the risk that other organs may prolapse, limiting pelvic pain and problems such as fistulas and incontinence.
For patients who would like to try to have children, a hysterectomy is not an option. Uterine prolapse surgery can be performed in a way that will attempt to preserve the possibility of carrying children to term and delivering them. A pregnancy can put considerable strain on the uterus and the pelvic floor, however, and it may not be possible for women to have children after a uterine prolapse repair. Women who are interested in children should weigh their treatment options carefully before committing to surgery.
Generally, abdominal procedures are more invasive, but more effective. Some surgeons offer laparoscopic procedures for uterine prolapse surgery. These procedures involve the introduction of instruments and a camera through small incisions in the abdomen to access the surgical site without making a large open incision. Recovery time from laparoscopic surgeries is much shorter and patients generally experience less pain and discomfort.
Prolapses can recur after surgery. If a surgeon attempts a repair without a hysterectomy, it is possible that the pelvic floor will weaken in the future, allowing the uterus to move out of place again. Strain such as pregnancy and childbearing can trigger a recurrence, and sometimes the uterus prolapses for no apparent reason. Doctors may recommend less invasive measures, such as the insertion of a vaginal pessary to support the uterus and pelvic floor, before asking a patient to consider surgery.
As with any surgery, patients should prepare ahead of time for uterine prolapse surgery by interviewing surgeons about their approaches to treatment and success rates. It is also advisable to get aftercare and recovery instructions before the surgery takes place, as this allows some time to prepare.