A surgical procedure to support the uterus

The stages of uterine prolapsed are graded by their severity, determined by how far the uterus has descended.

• 1st Degree: The cervix drops into the vagina
• 2nd Degree: The cervix drops to the level inside the opening of the vagina
• 3rd Degree: The cervix is outside the vagina
• 4th Degree: The entire uterus has fallen outside the vagina

Common complaints of women with uterine prolapse include not being able to wear a tampon, urinary and/or fecal incontinence, vaginal dryness or irritation, and pain with intercourse. Symptoms might not be noticeable, as they progress very gradually.

Symptoms may include:

• Leakage of urine or difficulty starting to urinate
• A bulging, pressure, or heavy sensation in the vagina that worsens by the end of the day or during a bowel movement
• Needing to push stool out of the rectum by placing fingers into or around the vagina during a bowel movement
• The need to lift the bulging vagina or uterus to start urination
• Lower back pain
• Aching, or feeling pressure, in your lower abdomen or pelvis

Uterine prolapse happens when the supporting ligaments of the uterus have broken, causing the uterus to fall. Many doctors recommend a hysterectomy when this happens. A hysteropexy offers an alternative option. It allows the option to preserve the uterus while solving the problem of uterine prolapse. This surgery can be performed with or without mesh, depending on the patient’s decisions and the surgeon’s recommendations.

This procedure allows the woman to preserve her fertility and uterus if she wishes. It also is a stronger repair option than a hysterectomy, with less risk of recurrent prolapse.

Surgical Technique

A hysteropexy is performed under general anesthesia, with three small laparoscopic incisions made into the abdomen. Two of these lines will be on the lower abdomen at your bikini line, and the third incision will be within your belly button, making the small incision invisible.

If mesh is used, one end of the mesh will be attached to the cervix using non-dissolvable stitches and the other to a ligament over the sacrum. This process gently lifts the uterus back up into its normal anatomical position. Once the procedure is done, dissolvable stitches or Dermabond (glue) will be used to close the small cuts in your abdomen.

Recovery from Hysteropexy

A catheter will be placed into the bladder for 24 hours after the surgery. Women are likely to experience discomfort or some pain for the first few days. Some women have slight vaginal bleeding and will need to wear a sanitary pad. Pads are recommended, instead of tampons, as tampons increase the chance of developing an infection.

If stitches were used on the abdomen for the surgery, they will dissolve on their own in two to four weeks. If glue was used, it will loosen from your skin on its own in seven to ten days. Depending on your surgery, you will need four to six weeks off work to recover. While recovery time varies, your body needs time to build new cells and repair itself.

Vaginal Health Center Urogynecologists are Experts in Female Pelvic Health

If you suffer from any of these symptoms, help is available. Our double board-certified urogynecologists are experts in female pelvic health, including diagnosing and treating urinary incontinence. Call us today at 770.721.6060 or request an appointment online.