Can Uterine Prolapse Surgery Be Done

Without Removing the Uterus?

Yes. Uterine prolapse surgery can sometimes be performed without removing the uterus. This approach is generally called hysteropexy, or uterine-preserving prolapse surgery, and works by suspending and supporting the uterus rather than performing a hysterectomy. Whether uterine preservation is appropriate depends on prolapse type and severity, uterine health, age, future pregnancy plans, previous surgery, and patient preference.

Can Uterine Prolapse Be Repaired Without a Hysterectomy?

Yes.

A hysterectomy is not automatically required simply because the uterus has prolapsed.

There are two broad surgical approaches:

Uterine-preserving surgery → uterus remains in place and is resuspended

Hysterectomy-based repair → uterus is removed and appropriate pelvic support is reconstructed

Both approaches may be reasonable for selected patients.

What Is Uterine-Preserving Prolapse Surgery?

Uterine-preserving prolapse surgery restores support to the uterus while leaving it in place.

The goal is:

prolapsed uterus → restore apical support → reposition uterus → preserve uterus

These operations are commonly grouped under the term hysteropexy.

What Is Hysteropexy?

Hysteropexy means surgically suspending a prolapsed uterus.

Instead of removing the uterus, the surgeon attaches or supports it using pelvic ligaments, sutures, or—in selected procedures—mesh.

Different techniques can be performed depending on the patient's anatomy.

What Types of Hysteropexy Are Available?

Uterine-preserving approaches may include:

• Vaginal hysteropexy
• Sacrospinous hysteropexy
• Laparoscopic hysteropexy
• Abdominal hysteropexy
• Sacrohysteropexy

The recommended procedure depends on prolapse anatomy, surgeon expertise, uterine health, and other pelvic-floor problems.

What Is Sacrospinous Hysteropexy?

Sacrospinous hysteropexy is a vaginal uterine-preserving procedure.

The uterus or cervix is supported using strong pelvic ligament structures.

It can avoid removal of the uterus while restoring apical support.

What Is Sacrohysteropexy?

Sacrohysteropexy is another uterine-preserving operation.

The uterus or cervix is suspended toward the sacrum to restore support.

It may be performed through an abdominal or minimally invasive approach.

Some sacrohysteropexy techniques use surgical mesh, so the specific risks and benefits should be discussed before surgery.

Is Hysteropexy the Same as Hysterectomy?

No.

The difference is fundamental:

Hysteropexy → uterus stays

Hysterectomy → uterus is removed

Both procedures may include additional pelvic-floor repairs if other prolapse compartments are involved.

Why Would Someone Want to Keep the Uterus?

Reasons may include:

• Personal preference
• Desire to avoid organ removal
• Future fertility considerations
• Preference for uterine preservation
• Potential surgical considerations

There is no requirement that every woman with prolapse must feel comfortable removing her uterus.

Who May Be a Candidate for Hysteropexy?

Potential candidates may include women who:

• Have symptomatic uterine prolapse
• Want to preserve the uterus
• Have no clear uterine condition requiring removal
• Have anatomy suitable for uterine suspension
• Understand the potential benefits and risks

Final candidacy requires an in-person pelvic examination.

Who May Not Be a Good Candidate?

Hysterectomy may sometimes be preferred when there are additional uterine or cervical concerns.

Examples may include:

• Certain abnormal uterine bleeding
• Significant uterine disease
• Certain cervical abnormalities
• Some uterine masses
• Other conditions requiring uterine removal

These conditions should be properly evaluated before deciding on uterine preservation.

Can Stage 2 Uterine Prolapse Be Repaired Without Hysterectomy?

Potentially, yes.

Stage 2 prolapse does not automatically require hysterectomy—or even surgery.

Options may include:

• Pelvic-floor therapy
• Pessary
• Uterine-preserving surgery
• Hysterectomy-based repair when appropriate

Symptoms are important when deciding whether surgery is necessary.

Can Stage 3 Uterine Prolapse Be Repaired Without Removing the Uterus?

Potentially.

More advanced prolapse does not automatically rule out hysteropexy.

The surgeon should evaluate:

• Degree of uterine descent
• Cervical position
• Vaginal support
• Bladder prolapse
• Rectocele
• Tissue quality

The entire pelvic floor matters.

Can Stage 4 Uterine Prolapse Be Treated Without Hysterectomy?

Potentially in selected patients.

Advanced prolapse requires more detailed surgical planning, but uterine preservation may still be discussed depending on anatomy and patient goals.

A pessary may also remain an option for some patients who do not want surgery.

Can Bladder Prolapse Be Repaired While Keeping the Uterus?

Yes, potentially.

Uterine prolapse frequently occurs together with anterior vaginal wall prolapse.

The surgical plan may therefore involve:

uterine suspension + anterior vaginal wall repair

when both areas require treatment.

Can Rectocele Be Repaired at the Same Time?

Yes.

If posterior vaginal wall prolapse is also present, it may potentially be repaired during the same operation.

A patient may therefore have:

hysteropexy + anterior repair + posterior repair

depending on the anatomy.

Why Is Apical Support Important?

The uterus and upper vagina are part of the apical support system.

If this support is weak, repairing only the bladder or posterior vaginal wall may not adequately address the overall prolapse.

Successful surgical planning should therefore evaluate the entire pelvic support structure.

Is Hysteropexy Better Than Hysterectomy?

Not automatically.

Neither operation is universally best.

Hysteropexy

Potential advantages include:

• Preserves the uterus
• Avoids hysterectomy
• May reduce operative extent in some cases

Hysterectomy-Based Repair

May be appropriate when:

• Uterine disease is present
• Uterine preservation is not desired
• Another surgical strategy is preferred

The best procedure depends on the individual patient.

Is Hysteropexy Less Invasive?

Sometimes, but not always.

Avoiding hysterectomy may reduce part of the surgical procedure, but hysteropexy is still significant pelvic-floor surgery.

Recovery depends on:

• Surgical approach
• Number of repairs
• Vaginal incisions
• Laparoscopic or abdominal surgery
• Patient health

“Uterus-preserving” should not automatically be interpreted as minor surgery.

Is Mesh Required for Uterine-Preserving Surgery?

No.

Some uterine-preserving procedures use the patient's own tissues and sutures.

Other approaches, such as certain sacrohysteropexy procedures, may use mesh.

Patients should ask:

• Is mesh being used?
• What type?
• Why is it recommended?
• What are the alternatives?
• What are the short- and long-term risks?

The exact surgical technique matters.

Is Mesh Safe?

Mesh has potential benefits and procedure-specific risks.

Potential complications can include:

• Mesh exposure or erosion
• Pain
• Infection
• Injury to nearby structures
• Need for additional treatment

Mesh should therefore be discussed through informed consent rather than presented as automatically better or worse.

Can Uterine Prolapse Return After Hysteropexy?

Yes.

No prolapse surgery guarantees permanent correction.

Recurrence may involve:

• Uterine/apical prolapse
• Anterior vaginal wall
• Posterior vaginal wall
• Another pelvic compartment

Long-term results depend on both surgical technique and patient factors.

Does Hysterectomy Prevent Prolapse Recurrence?

No.

Removing the uterus does not make future prolapse impossible.

After hysterectomy, patients can still develop:

• Vaginal vault prolapse
• Bladder prolapse
• Rectocele
• Other apical prolapse

Appropriate vaginal support remains important.

Is Hysteropexy as Effective as Hysterectomy?

Both uterine-preserving and hysterectomy-based approaches are recognized surgical options for uterine prolapse.

However, outcomes depend on the specific technique and patient.

The comparison should consider:

• Recurrence
• Complications
• Recovery
• Uterine health
• Patient preference

rather than assuming one approach is always superior.

Can I Have Hysteropexy If I Want Children?

Future pregnancy requires special consideration.

Preserving the uterus does not automatically mean that pregnancy after prolapse surgery is recommended.

Pregnancy and childbirth can place significant stress on a previous pelvic-floor repair.

Women planning additional pregnancies may sometimes be advised to delay definitive prolapse surgery and use conservative treatment first.

Can I Use a Pessary Instead of Surgery?

Yes, potentially.

A pessary may provide mechanical support without surgery.

It may be particularly useful when a patient:

• Wants to avoid surgery
• Wants future pregnancy
• Wants to delay surgery
• Has medical risks
• Prefers conservative management

Some women use pessaries long-term.

Do I Need Surgery at All?

Not necessarily.

Uterine prolapse treatment may include:

• Observation
• Pelvic-floor physical therapy
• Pessary
• Lifestyle management
• Surgery

The presence of prolapse alone does not mean an operation is required.

When Is Surgery Usually Considered?

Surgery may be considered when:

• Vaginal bulging is significant
• Pelvic pressure affects daily life
• Bladder or bowel function is affected
• Conservative treatment is insufficient
• A pessary cannot be comfortably used
• The patient prefers surgical correction

Treatment should be driven largely by symptoms and quality of life.

How Long Is Hysteropexy Recovery?

Recovery generally takes several weeks, depending on the operation.

Early recovery may involve:

• Pelvic soreness
• Light vaginal bleeding
• Fatigue
• Activity restrictions

Heavy lifting, strenuous exercise, and vaginal intercourse are usually restricted during early healing.

When Can I Return to Work?

This depends on:

• Surgical approach
• Job type
• Additional repairs
• Individual recovery

Desk work may be possible sooner than physically demanding work.

When Can I Have Sex After Hysteropexy?

Vaginal intercourse should wait until adequate healing has occurred.

The exact timing depends on the procedure and postoperative examination.

Patients should receive clearance from their surgeon.

Can I Exercise After Uterine Prolapse Surgery?

Yes, but activity should return gradually.

Early recovery generally focuses on walking and light activity.

Higher-impact exercise and heavy resistance training usually require more healing time.

What Are the Risks of Uterine-Preserving Prolapse Surgery?

Potential risks vary by technique but may include:

• Bleeding
• Infection
• Pain
• Urinary problems
• Injury to surrounding structures
• Prolapse recurrence
• Pain during intercourse
• Procedure-specific mesh complications when mesh is used

The surgeon should explain risks for the exact operation being proposed.

What Should I Ask My Surgeon?

Important questions include:

• Can my uterus be preserved?
• Why are you recommending hysteropexy or hysterectomy?
• What type of hysteropexy would you perform?
• Will mesh be used?
• Do I also have cystocele or rectocele?
• What is my recurrence risk?
• How long is recovery?
• How long should I avoid lifting?
• When can I have sex?
• What happens if prolapse returns?

Patients should understand the alternatives before deciding.

Uterine-Preserving Prolapse Surgery in Korea for Foreigners

International patients seeking uterine prolapse surgery in Korea should clearly communicate if uterine preservation is important to them.

Useful medical information includes:

• Age
• Childbirth history
• Prolapse diagnosis
• POP-Q stage if known
• Previous pelvic surgery
• Previous hysterectomy recommendations
• Abnormal bleeding history
• Fibroids or uterine conditions
• Cervical screening history
• Future pregnancy plans

Final surgical planning usually requires an in-person pelvic examination.

How Somssi Women’s Clinic Approaches Uterine Preservation

At Somssi Women’s Clinic in Seoul, uterine prolapse should not automatically lead to hysterectomy.

Evaluation should determine:

• What is prolapsing?
• How advanced is the prolapse?
• Is the uterus healthy?
• Are the bladder or rectum also prolapsing?
• Does the patient want uterine preservation?
• Are conservative treatments still reasonable?
• Which surgical approach best addresses the actual support defect?

The goal is an individualized treatment plan rather than routine uterine removal.

Frequently Asked Questions

Can uterine prolapse surgery be done without removing the uterus?

Yes. Uterine-preserving prolapse surgery is possible for selected patients.

What is the surgery called?

It is generally called hysteropexy.

What is the difference between hysteropexy and hysterectomy?

Hysteropexy preserves and supports the uterus. Hysterectomy removes it.

Is hysterectomy always necessary for uterine prolapse?

No.

Can Stage 2 prolapse be repaired while keeping the uterus?

Potentially, yes.

Can Stage 3 prolapse be repaired without hysterectomy?

Potentially.

Can Stage 4 prolapse preserve the uterus?

Potentially in selected patients.

Can bladder prolapse be repaired at the same time?

Yes, when appropriate.

Can rectocele be repaired at the same time?

Yes.

Does hysteropexy require mesh?

Not always.

What is sacrohysteropexy?

It is a uterine-preserving procedure that suspends the uterus or cervix toward the sacrum.

What is sacrospinous hysteropexy?

It is a vaginal procedure that supports the uterus using pelvic ligament structures.

Can prolapse return after hysteropexy?

Yes.

Does hysterectomy guarantee prolapse will not return?

No.

Is hysteropexy better than hysterectomy?

Neither is universally better.

Can I get pregnant after hysteropexy?

Pregnancy may be possible after some procedures, but future pregnancy requires careful specialist counseling.

Should I delay surgery if I want more children?

This may be recommended for some patients.

Can I use a pessary instead?

Yes, potentially.

Does every uterine prolapse need surgery?

No.

How long does recovery take?

Usually several weeks, depending on the procedure.

Can foreigners have uterus-preserving prolapse surgery in Korea?

Yes, when medically appropriate and the required surgical expertise is available.

Can You Keep Your Uterus and Still Fix Uterine Prolapse?

For selected patients, yes.

The treatment pathway may be:

diagnose uterine prolapse → assess stage and other pelvic compartments → evaluate uterine health → discuss pessary vs surgery → compare hysteropexy vs hysterectomy → select the appropriate repair

At Somssi Women’s Clinic in Seoul, a hysterectomy should not be assumed to be the only surgical solution for uterine prolapse.

For women who want to keep their uterus and are medically suitable, uterine-preserving prolapse surgery such as hysteropexy may provide another option.

The decision should ultimately consider the patient's uterine health, prolapse anatomy, symptoms, future pregnancy plans, recurrence risk, surgical risks, and personal preference.