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Surgical treatments for uterine prolapse primarily fall into two categories: uterine-sparing procedures and hysterectomy (removal of the uterus). These operations can be performed incision-free via the vaginal route, or through minimally invasive methods such as laparoscopic or robotic surgery via the abdomen.
When planning treatment, a comprehensive evaluation is conducted, considering the degree of prolapse, the anatomical compartments affected, the patient's age, general health status, and personal preferences. Since the primary problem in prolapse is not the uterus itself but the weakness of its supporting structures, uterine-sparing surgeries are prioritized in suitable cases. However, if there is an additional pathology in the uterus (e.g., fibroids, precancerous lesions), procedures involving the removal of the uterus and suspension of the remaining tissues may be preferred.
These operations, based on supporting or suspending the prolapsed tissues, either utilize the patient's own tissues (autologous grafts) to fix organs in their anatomical positions, or more commonly, synthetic mesh implants are used to support the prolapsed organs with the strong pelvic structures within the pelvic bone.
The decision for surgery and its timing are largely determined by the severity of the patient's symptoms. For instance, a patient with Stage 1 prolapse who is significantly bothered in her social life may undergo surgery immediately, whereas a patient with Stage 4 prolapse who has no significant complaints and states she can live with the condition, may have her operation postponed until she desires it. In short, the fundamental factor determining the decision and timing of surgical intervention is the level of discomfort the patient experiences from her symptoms.
Not every woman with uterine prolapse experiences urinary incontinence. In fact, the degree of prolapse can sometimes mask underlying occult incontinence. This term refers to latent stress urinary incontinence that may become apparent after prolapse surgery. Such conditions are identified through special pre-operative examination methods, and if present, necessary operations for accompanying urinary incontinence problems are also included in the treatment plan.
How is Uterine Prolapse treated surgically?
When planning treatment, a comprehensive evaluation is conducted, considering the degree of prolapse, the anatomical compartments affected, the patient's age, general health status, and personal preferences. Since the primary problem in prolapse is not the uterus itself but the weakness of its supporting structures, uterine-sparing surgeries are prioritized in suitable cases. However, if there is an additional pathology in the uterus (e.g., fibroids, precancerous lesions), procedures involving the removal of the uterus and suspension of the remaining tissues may be preferred.
These operations, based on supporting or suspending the prolapsed tissues, either utilize the patient's own tissues (autologous grafts) to fix organs in their anatomical positions, or more commonly, synthetic mesh implants are used to support the prolapsed organs with the strong pelvic structures within the pelvic bone.
The decision for surgery and its timing are largely determined by the severity of the patient's symptoms. For instance, a patient with Stage 1 prolapse who is significantly bothered in her social life may undergo surgery immediately, whereas a patient with Stage 4 prolapse who has no significant complaints and states she can live with the condition, may have her operation postponed until she desires it. In short, the fundamental factor determining the decision and timing of surgical intervention is the level of discomfort the patient experiences from her symptoms.
Not every woman with uterine prolapse experiences urinary incontinence. In fact, the degree of prolapse can sometimes mask underlying occult incontinence. This term refers to latent stress urinary incontinence that may become apparent after prolapse surgery. Such conditions are identified through special pre-operative examination methods, and if present, necessary operations for accompanying urinary incontinence problems are also included in the treatment plan.