Uterine Prolapse Repair

What is uterine prolapse?

Uterine prolapse occurs when your uterus (womb) drops down into the vaginal canal due to weakened or stretched pelvic floor muscles and supporting tissues. In severe cases, the uterus may even protrude outside your vagina. This condition is common after childbirth, menopause, or as you age, and it can cause discomfort, pressure, or difficulty with daily activities.

Uterine prolapse repair is a surgical procedure to restore the uterus to its normal position or, in some cases, remove the uterus entirely (hysterectomy). The goal of the surgery is to relieve symptoms, improve your quality of life, and prevent further complications.

Why might you need uterine prolapse repair?

You might need this surgery if you experience:

• A feeling of heaviness or dragging in your pelvis
• A visible or noticeable bulge in or outside your vagina
• Difficulty emptying your bladder or bowels
• Discomfort or pain during intercourse
• Recurrent urinary tract infections

If these symptoms are interfering with your daily life and treatments like pelvic floor exercises or vaginal pessaries have not worked, your doctor may recommend surgical repair.

Types of uterine prolapse repair

There are different surgical options for uterine prolapse repair. Your consultant will recommend the best option based on the severity of your prolapse, your overall health, and whether you wish to preserve your uterus.

• Hysteropexy: This surgery lifts and secures your uterus in its normal position using your own tissue, stitches, or a surgical mesh. Hysteropexy is suitable if you want to keep your uterus and maintain fertility.
• Hysterectomy: If preserving the uterus is not a priority, a hysterectomy may be performed to remove the uterus entirely. This can prevent further prolapse and relieve symptoms.
• Sacrohysteropexy: A type of hysteropexy where the uterus is attached to the sacrum (a bone at the base of your spine) using surgical mesh. This procedure provides strong and long-lasting support.

Your surgeon will discuss the pros and cons of each option with you, ensuring you have all the information needed to make an informed decision.

What happens during the procedure?

Uterine prolapse repair is performed under general or regional anaesthesia. Depending on the technique used, the surgery may be done vaginally, laparoscopically (keyhole surgery), or through open surgery.

If a hysteropexy is performed, your uterus will be lifted and secured using sutures or surgical mesh. If a hysterectomy is necessary, your uterus will be carefully removed, and the remaining tissues will be strengthened to prevent further prolapse.

The procedure usually takes 1–2 hours, and most patients can go home the same day or after a short hospital stay.

Recovery after uterine prolapse repair

Recovery times vary depending on the type of surgery, but most women can return to normal activities within 4–6 weeks. During recovery:

• Avoid heavy lifting, strenuous activities, or high-impact exercises for at least 6 weeks.
• Take short, gentle walks to promote healing and improve circulation.
• Follow your doctor’s advice on managing pain and caring for your stitches.
• Avoid inserting anything into your vagina, such as tampons, and refrain from sexual intercourse until your doctor confirms it is safe.

It’s normal to experience some light vaginal bleeding or discharge for a few weeks after surgery. Your doctor will schedule follow-up appointments to monitor your recovery and ensure everything is healing as expected.

Benefits of uterine prolapse repair

Surgical repair can relieve the uncomfortable symptoms of uterine prolapse, such as pressure, discomfort, and bladder or bowel difficulties. Many women find that their quality of life improves significantly, allowing them to return to daily activities with confidence.

Risks of uterine prolapse repair

As with any surgery, there are potential risks, including:

• Infection or bleeding
• Pain or discomfort during intercourse
• Difficulty urinating or temporary use of a catheter
• Recurrence of the prolapse
• Mesh-related complications (if mesh is used)

Your consultant will discuss these risks with you and explain how they will minimise them during your care.

How to support your pelvic floor after surgery

In addition to surgery, adopting healthy lifestyle habits can help support your pelvic floor and improve long-term outcomes:

• Perform regular pelvic floor exercises to strengthen the muscles supporting your bladder, bowel, and vagina.
• Eat a high-fibre diet and stay hydrated to prevent constipation and reduce straining.
• Avoid heavy lifting and high-impact activities that could weaken your pelvic floor.
• Maintain a healthy weight to reduce pressure on your pelvic floor.

These steps can complement the benefits of surgery and help maintain your pelvic health.