Uterine Prolapse Treatment in Turkey: Restore Your Anatomy and Comfort
What causes uterine prolapse? Learn about the “falling out” sensation, back pain, and urinary issues. Discover uterus-sparing suspension surgery and vaginal hysterectomy in Istanbul with Dr. Cengiz Andan.
Uterine Prolapse is Not Your Destiny; It is Treatable
The uterus is held in place within the pelvis by a “hammock” of strong muscles and ligaments. However, over time, aging, difficult childbirths, or menopause can cause these support structures to weaken and break. As a result, the uterus slides down the vaginal canal due to gravity, and in advanced stages, protrudes out of the vagina. This condition is medically known as Uterine Prolapse.
Women often describe this as feeling a “bulge between their legs” or like they are “sitting on a ball.” It is not just a physical discomfort but a serious health issue that brings urinary incontinence and sexual problems.
At Dr. Cengiz Andan’s Clinic, our approach to treating uterine prolapse is tailored to the patient’s age and desire for future children, choosing between Uterus-Sparing Suspension or Removal and Repair.
- Why Does Uterine Prolapse Happen? Why Do Ligaments Break?
Prolapse is rarely due to a single cause; it is usually the result of wear and tear over years.
Risk Factors:
- Vaginal Births: Delivering large babies, having multiple births, or difficult (vacuum-assisted) deliveries can tear the pelvic floor muscles.
- Menopause and Aging: Estrogen gives elasticity to tissues. As estrogen levels drop during menopause, ligaments loosen.
- Increased Abdominal Pressure: Chronic coughing (asthma/smoking), chronic constipation (straining), and a lifestyle involving heavy lifting.
- Genetics: Some women are born with naturally weaker connective tissue (collagen).
- Symptoms and Stages: How Serious Is It?
Prolapse is graded in four stages, from mild to severe.
- Stage 1: The uterus has dropped slightly; the patient may not feel it.
- Stage 2: The cervix has descended to the vaginal opening.
- Stage 3: The uterus protrudes outside the vaginal opening (Patient can feel the bulge).
- Stage 4 (Total Prolapse): The entire uterus is outside the body.
Common Symptoms:
- Bulge Sensation: A soft tissue protruding from the vagina.
- Heaviness: A feeling of fullness or dragging in the pelvis and vagina.
- Back Pain: Dull ache in the lower back caused by stretching uterine ligaments.
- Urinary & Bowel Issues: Leaking urine, frequent urination, or constipation.
- Difficulty Walking: In advanced stages, friction makes walking difficult and can cause bleeding sores (ulcers).
- Treatment Methods: To Remove or To Suspend?
The treatment plan depends on the degree of prolapse, patient age, sexual activity status, and whether she wants to keep her uterus.
- Non-Surgical Methods (Mild Cases & Elderly Patients):
- Kegel Exercises: Strengthening pelvic floor muscles can slow the progression of early-stage prolapse.
- Pessary (Ring) Use: For patients too elderly or high-risk for surgery, silicone rings inserted into the vagina can mechanically hold the uterus up. Requires maintenance.
- Uterus-Sparing Surgery (Hysteropexy):Performed for young patients, those desiring children, or those who wish to keep their uterus.
- Laparoscopic Sacrocolpopexy (The Gold Standard): Performed via keyhole surgery through the abdomen. The prolapsed uterus is suspended to the strong ligament on the tailbone (sacrum) using a synthetic mesh. This is anatomically the strongest method with the lowest recurrence risk (<5%).
- Vaginal Hysterectomy (Removing the Uterus):Preferred if the patient is post-menopausal, has completed her family, and the uterus is completely prolapsed.
- The Procedure: The uterus is removed through the vagina without any abdominal incisions. However, removing the uterus isn’t enough; the top of the vagina (cuff) must be suspended to strong ligaments (Cuff Suspension) to prevent it from falling in the future.
- Recovery Process
Patient satisfaction after prolapse surgery is very high.
- Hospital Stay: Usually 1 or 2 nights.
- Recovery: Patients can walk the next day. 1 week of rest at home is sufficient.
- Important Precautions: To ensure success, patients must avoid lifting anything heavier than 5kg, avoid constipation, and follow sexual abstinence guidelines for the first 2-3 months.
Frequently Asked Questions (Uterine Prolapse)
- Will uterine prolapse fix itself?Answer:No. Broken ligaments or stretched tissues cannot snap back on their own. Exercises only strengthen muscles but cannot lift a prolapsed organ back up. Surgery is mandatory for advanced stages.
- Will my sex life end after surgery?Answer:No, on the contrary, it improves. The physical barrier and aesthetic concern caused by the prolapsed uterus are removed. Additionally, if vaginal tightening is performed during surgery, sexual pleasure increases.
- Is vaginal or laparoscopic surgery better?Answer:This depends on the patient. For sexually active, younger patients, the Laparoscopic method is preferred to preserve vaginal length and provide stronger suspension. For older patients who are not sexually active, the Vaginal method may be more practical.
- Will the prolapse come back after surgery?Answer:With the correct technique (especially mesh suspension), the risk of recurrence is very low. However, if the patient does not maintain a healthy lifestyle (avoids heavy lifting, excessive weight gain), tissues can stretch again over the years.
- Is a pessary a permanent solution?Answer:No, a pessary is a temporary solution or for those who cannot have surgery. It must be removed and cleaned or replaced every 3-6 months. If left unchecked for too long, it can cause vaginal sores.
Dr. Cengiz Andan aims to free you from both the physical burden and aesthetic worries of uterine prolapse using advanced organ-preserving laparoscopic techniques.
