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Hysterectomy for Prolapse

From the Pre-Op Hysterectomy Articles List


Woman wondering about hysterectomy for prolapseMy doctor explained that I have uterine prolapse. What are the treatment options and what is involved with a uterine prolapse, cystocele and rectocele?

Uterine prolapse has been described by women, in the vernacular, as “having your insides fall out.” Put simply, prolapse is the uterus descending into the vaginal canal. A prolapse is not, in most cases, life-threatening; it is by most accounts “quality-of-life-threatening.” Studies show that about 15% of hysterectomies are performed to correct prolapse. Some of those hysterectomies could be avoided with alternatives, such as using a pessary, or undergoing uterine suspension surgery.

A pessary is a rubber, ring-shaped device worn in the vagina to help reposition and support the uterus. Doing Kegel exercises, losing excess weight, and quitting smoking can all enhance the results of pessary use. For women who wish to preserve their uterus for childbearing, another option is uterine suspension. Uterine suspension surgery is not viewed as a permanent cure; its effects usually don’t last a lifetime. After childbearing is completed, most doctors will recommend a hysterectomy as the best permanent solution for prolapse.

What causes prolapse? Pregnancy and childbirth are major contributors. Heredity, obesity, poor nutrition, smoking, chronic constipation, chronic coughing, frequent heavy lifting, estrogen loss after menopause, pressure from fibroids, and simple aging and gravity can also contribute to developing the condition. Complications of uterine prolapse can include incontinence, vaginitis, cystitis, and a higher risk of uterine cancer.

The first symptom of prolapse is usually urinary incontinence. Because the uterus supports or rests on a variety of other organs, a uterine prolapse can be associated with prolapse of other pelvic organs such as:
  • Cystocele: This is a falling bladder, which may feel as though you cannot empty your bladder completely, and may have a urinary tract infection or stress incontinence.
  • Enterocele: The small intestine falls into the back of the vagina.
  • Rectocele: The rectum falls into the vagina, causing constipation. Stools may also back into a sort of pouch, forming a bulging rectum.
  • Urethrocele: The muscles supporting the urethra separate, and the urethra sags into the vagina.
Many women are relieved and happy to discover that their hysterectomy for prolapse improves their quality of life. But because a hysterectomy is a major, life-altering surgery, it is advisable to investigate other options for treating prolapse before proceeding with a hysterectomy.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

04-29-2003 - 04:37 PM


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