Genital Aesthetic

Uterine Prolapse Surgery

What is Uterine Prolapse?
In mammals, the organ where the fertilized egg implants, grows and develops until the time of birth is called the uterus. While it is 5-6 cm in size in women who have never given birth, it is 6-7 cm in size in women who give birth. It is in the pelvis, behind the bladder, in the front of the large intestine. It has a dark pink color.
The organs of the genital area have limited mobility due to the ligaments that hold them in place. Ligaments may lose their functions due to age progression, number of births and shape. It is usual for the genital organs to sag into the vagina as the ligaments loosen. Uterine prolapse is the sliding of the uterus down in the vagina as a result of some factors.

What is the Cause of Uterine Prolapse?

  • Having many pregnancies
  • Giving normal birth
  • Having a large baby
  • Advanced age
  • Lifting heavy loads
  • Coughing constantly
  • Chronic constipation and straining
  • Obesity
  • Excessive stretching of the muscles and connective tissue around the abdomen as a result of some lung diseases

What are the symptoms of uterine prolapse?
Symptoms can vary depending on the person's degree of illness. If you have an early stage sagging problem, there may usually be no symptoms at all. The complaints of the patient usually start in the early morning hours, and increase towards the evening hours. If you have moderate to severe uterine prolapse, you may have the following symptoms;
* Experiencing lower back pain
* Something coming out of the vagina
* Feeling of heaviness around the lower abdomen or pulling downwards
* Feeling pain during sexual intercourse

Which Complaints Does Uterine Prolapse Cause?
There are different degrees of sagging. As a result of excessive sagging, the woman becomes able to feel her uterus with her hand. Even in the following cases, the uterus may come out of the vagina completely. In general, not only the uterus, but also the large intestine and bladder next to it can be affected by the uterine prolapse. Women who experience uterine prolapse cause them to feel fullness and pain in their lower regions, especially in standing positions, during straining, coughing and sneezing. In those who experience sagging of the rectum (end of the large intestine) with the uterus, the rectum gets closer to the vagina. This sagging also brings constipation problem. In women with prolapse in the bladder, the problem of incontinence and difficult urination occurs in the standing state, during sexual intercourse and during laughing, depending on the severity of the prolapse. As a result of the sagging of the organs of the genital area, the inability to enjoy the sexual life of the woman also occurs.

How Is Uterine Prolapse Diagnosed?
Women who experience this problem are generally aware of their uterine prolapse. However, sometimes it can be detected by looking at the findings even in women who have no problems. When women who experience urinary incontinence and a feeling of fullness in the lower region consult a doctor with this complaint, it can be easily detected as a result of the gynecological examination.

How Is The Treatment Performed?
Treatment for uterine prolapse may vary from patient to patient. The age of the woman to be treated, whether or not she wants to have a child, the degree of the disease, and the general health status of the woman also change the form of treatment. For people within the early stages of the problem, sagging can be partially stopped by exercising the muscles around the vagina, which are called Kegel exercises. In case of advanced uterine prolapse, surgical operation becomes inevitable as exercise treatments cannot eliminate any problems. The method of treatment planned as a result of genital organ prolapse in women who have had children before or are planning to give birth is usually removing the uterus from the vagina and performing vaginal tightening by removing the excess parts of the anterior vaginal walls. Women who have undergone vaginal tightening operation should give birth by cesarean instead of normal birth in case of pregnancy. For women in reproductive age who has the idea of giving birth and does not want her uterus to be removed, the uterus is not taken. Repair of the enlargement is accomplished by narrowing the vagina, by removing only the excess tissue on the anterior and posterior vaginal walls. Thus, the complaints of women suffering from vaginal enlargement after childbirth is reduced.
Sexual life problems are also corrected, and ensured to become satisfied more than before. If the uterine prolapse is evident, it is possible to reach the ligaments that hold the uterus in the abdomen, strengthen these ligaments by pulling up, and as a result, there is no need to remove uterus any longer. However, pull-up operations are not a very long-lasting treatment method. Depending on the type and technique of this type of operation, there is a risk of recurrence of the sagging problem within an average of 5 years. Vaginal surgeries take approximately 1 - 1.5 hours. However, in complaints such as uterine prolapse, the operation time is around 3 hours on average. Sexual intercourse is prohibited for 6 weeks after the operation. The patient becomes able to do his daily work after a while. However, it may take 4 to 6 weeks for the wound in the vagina to fully heal. You can take a shower during this time. However, environments such as sea, pool, spa and sauna are prohibited for the patient.

What Can Be Done To Prevent Uterine Prolapse?
It is not possible to prevent the problem of uterine prolapse. However, it is possible to reduce the risk factors in your life. Eating healthy and not gaining excessive weight are the primary measures to be taken. It will also be helpful to do exercises to strengthen the muscles in the base of the abdomen. For example; It would be a good exercise to squeeze the muscles in the vagina and count to five as if stopping urination while urinating. It is necessary to repeat this many times a day. If you have a habit of smoking, you should quit it. If you have a disease that constantly makes you cough and if you have chronic constipation, seek treatment with consultation from doctors. Taking auxiliary estrogen hormone during menopause prevents the relaxation of the muscles. However, you should know that taking hormone therapy has its own risks, and you should decide to be treated with your doctor..

  • Op.Dr. Zeynep Taşargöl
    Obstetrics and Gynecology Specialist

    You can send me your questions and comments about Uterine Prolapse Surgery via this field. The answers provided are advisory. You need to be examined by your doctor for diagnosis and treatment.