Pelvic Organ Prolapse · Patient guide
Can Uterine Prolapse Surgery Be Done Without Removing the Uterus?
Yes. Uterine prolapse surgery can be done without removing the uterus through an operation called hysteropexy, in which the uterus is lifted back into position and fixed to its own supporting tissue. At Somssi Women's Clinic in Gangnam, Seoul, Dr. Yoon Ho-joo performs hysteropexy with culdoplasty and a native-tissue posterior repair as the standard operation for prolapse, without mesh, in about an hour with same-day discharge.
Medically reviewed by Dr. Yoon Ho-joo, MD, PhD, OB/GYN specialist, Somssi Women's Clinic · Last updated October 2026
At a glance
Key facts
The essentials, based on how Somssi Women's Clinic performs this procedure or answers this question. Your plan is confirmed at consultation.
- Short answer: yes, through a hysteropexy (uterine suspension)
- How the uterus is held: repositioned and fixed by gathering and tying the supporting tissue around the cervix; lifted about 2 to 4 cm in the clinic's experience
- Done together with: culdoplasty, posterior colporrhaphy and pelvic floor restoration with your own tissue; no mesh
- Procedure time: about 50 minutes to 1 hour under sedation plus local anesthesia
- Hospital stay: none; same-day discharge after urinating
- Recovery: desk work within days, golf at 1 week, vigorous exercise at 6 weeks, intercourse after 7 to 8 weeks
- Best suited to: stage 1 to 2 prolapse; stage 3 to 4 may need a hospital-based approach
Yes, uterine prolapse can be repaired without removing the uterus. The operation is called hysteropexy, from the Greek for "fixing the uterus", and it treats the real problem, the failed support, while leaving the organ in place. For most women with stage 1 to 2 prolapse it is the approach we recommend first.
Why removing the uterus is not necessary
The uterus descends because the uterosacral and cardinal ligaments and the pelvic floor beneath them have stretched. Removing the uterus takes away the organ that dropped but does nothing for the ligaments or the vaginal walls, which is why hysterectomy for prolapse must be combined with a suspension of the vaginal top, and why the vaginal vault can prolapse later. A hysteropexy repairs the support directly and keeps your anatomy intact.
Somssi Women's Clinic is a surgical gynecology clinic in Gangnam, Seoul, founded in 2000 and led by Dr. Yoon Ho-joo, MD, PhD. Uterus-preserving, native-tissue repair has been the clinic's standard prolapse operation for many years, and women are regularly referred here after being told elsewhere that hysterectomy was their only option.
How uterus-preserving surgery works at Somssi
Step 1: measure
Before surgery we record the stage of prolapse (POP-Q 0 to 4), total vaginal length, the thickness of the vaginal wall and the strength of the pelvic floor, and perform an ultrasound of the uterus, ovaries and tubes. A healthy uterus on ultrasound is the main requirement for keeping it.
Step 2: hysteropexy
Working through the vagina, Dr. Yoon repositions the uterus and gathers and ties the supporting tissue around the cervix so it holds the uterus at its restored height, roughly 2 to 4 centimeters higher in the clinic's experience. No mesh, suture tape or implant is used; the fixation relies on your own tissue.
Step 3: culdoplasty
The cul-de-sac, the pouch behind the cervix, is closed so that bowel cannot push down behind the uterus later. This long-established step supports the upper vagina and protects the hysteropexy.
Step 4: posterior repair and pelvic floor restoration
Because the back wall and perineum have almost always weakened as well, they are rebuilt in the same session. The mucosa is peeled to under 1 millimeter rather than cut, the pelvic floor muscles are gathered and sutured, and the wall is closed in a second layer, thickening it by about 2 to 3 centimeters. A figure-8 suture strengthens the muscles at the opening and the perineum is restored. The anterior wall is left alone to protect the bladder and urethra. Details are on the uterine prolapse surgery page.
Hysteropexy compared with hysterectomy
| Hysteropexy at Somssi | Hysterectomy with vault suspension | |
|---|---|---|
| Uterus | Kept | Removed |
| Approach | Vaginal, native tissue, no mesh | Vaginal, abdominal or laparoscopic; some techniques use mesh |
| Anesthesia | Sedation plus local; local alone possible | General or regional |
| Hospital stay | Same-day discharge | Usually 1 to several days |
| Fertility | Preserved | Ended |
| Future cervical screening | Continues | Usually stops |
| Recurrence | Possible; similar to hysterectomy in comparative studies | Possible (vault prolapse) |
What the clinic's experience shows
The clinic reported a 2026 retrospective series of 150 women with pelvic organ prolapse in which 74.7% chose uterus-preserving surgery and 85.3% reported improved quality of life; the abstract received an award at the Korean Society for Sexual Medicine meeting in May 2026. These are the clinic's own figures rather than an independent trial. Dr. Yoon has also presented on uterine prolapse and sexual function at WAS 2007 in Sydney and on mild genital prolapse at ESSM 2006 in Vienna, and his 2005 paper in the Korean Journal of Obstetrics and Gynecology examined sexual function after colpoperineoplasty.
Who is suitable and who is not
- Suitable: stage 1 to 2 uterine prolapse with symptoms; a healthy uterus and cervix on ultrasound and screening; women of any age, including long after menopause; women who want to keep fertility or simply their anatomy.
- Needs discussion: women planning pregnancy soon, since a later vaginal birth can stress the repair; women with fibroids or adenomyosis, which may be treated separately (the clinic offers HIFU for suitable cases).
- Usually not suitable at the clinic: stage 3 to 4 prolapse where the cervix reaches or protrudes beyond the opening, uterine or cervical cancer or precancer, or heavy abnormal bleeding; these may need a hospital-based operation, sometimes with hysterectomy, and we coordinate that referral honestly.
Recovery after uterus-preserving surgery
You walk shortly after waking and go home the same day once you have urinated. Desk work resumes within days, medication lasts about five days, sutures dissolve in about a week, golf is possible after a week, vigorous exercise and bathing after six weeks, and intercourse after seven to eight weeks. The result is assessed at about eight weeks. Patients from abroad manage follow-up remotely. See How Long Does Uterine Prolapse Surgery Recovery Take?.
Risks to understand
Hysteropexy shares the risks of any vaginal repair: bleeding, infection, rectal or cul-de-sac injury during the posterior repair, pain with intercourse if the canal is over-tightened, altered sensation, and recurrence. The uterus itself remains subject to the usual conditions, so cervical screening continues. We reduce risks with careful measurement, shallow dissection, sizing the canal to the cervix and realistic selection of who is suitable. Read Can Uterine Prolapse Come Back After Surgery? for the recurrence picture.
Bottom line
Uterine prolapse surgery does not require a hysterectomy. A hysteropexy with culdoplasty and native-tissue posterior repair restores the support that failed, keeps the uterus and is done at Somssi in about an hour with same-day discharge. It suits most women with stage 1 to 2 prolapse and a healthy uterus; advanced prolapse or uterine disease may call for a hospital-based operation, and an honest examination will tell you which applies. Contact us or read our international patients guide to plan a visit.
Private consultation
Talk it through with Dr. Yoon's team
English-speaking coordinators, a written treatment plan and a clear quote after your consultation. Same-day discharge for most procedures.
Mon, Tue, Wed, Fri, Sat 09:30–18:00 (KST). Closed Thu, Sun and holidays. 7F Sangkyung Building, 120 Teheran-ro, Gangnam-gu, Seoul.
Dr. Yoon Ho-joo, MD, PhD
OB/GYN specialist, Catholic University of Korea. Founder of Somssi Women's Clinic (2000). Published on female sexual function after reconstructive vaginal surgery; speaker at ESSM, ISSWSH, WAS and SMSNA.
Questions patients ask
Frequently asked questions
Short, honest answers. For anything personal, a consultation is the right place to ask.
Is hysteropexy as effective as hysterectomy for prolapse?
Comparative studies show similar prolapse control and symptom relief in the medium term when the apex is properly supported with either approach. Hysteropexy avoids removing an organ, shortens recovery and preserves fertility; hysterectomy avoids future uterine problems. For most women with a healthy uterus the choice comes down to preference and stage.
Does keeping the uterus mean I still need Pap smears?
Yes. The cervix remains, so cervical screening continues at the normal interval for your age. We check the cervix before surgery and can take a smear at the same visit if one is due.
Can I get pregnant after a hysteropexy?
Pregnancy is possible because the uterus is intact, but a later vaginal birth can stretch the repair. If you are planning a family, tell us; it may be better to delay surgery until after childbearing or to plan a cesarean delivery afterward. Each case is discussed individually.
What holds the uterus up if no mesh is used?
Your own supporting tissue around the cervix is gathered and tied to fix the uterus in its restored position, the cul-de-sac is closed beneath it, and the rebuilt posterior wall and pelvic floor carry the load from below. The repair relies on native tissue healing into a strong scar, which is why we protect it from strain for six to eight weeks.
I am 65. Is it too late to keep my uterus?
No. Age alone is not a reason for hysterectomy. Many of our patients are in their 60s and 70s. After menopause we may use vaginal estrogen for a few weeks before surgery to improve tissue quality, and recovery follows the same timeline.
What if my prolapse is advanced?
If the cervix reaches or protrudes beyond the opening (stage 3 to 4), the support defect is larger and a hospital-based operation, which may include hysterectomy or a different suspension, is sometimes the safer option. We examine you, explain the findings honestly and coordinate with hospital partners when that is the right path.
Keep reading
Related treatments and guides
- Uterine Prolapse Surgery — the full uterus-preserving procedure
- Pelvic Reconstructive Surgery — how the surrounding support is rebuilt
- Do I Need a Hysterectomy for Uterine Prolapse? — when removal is and is not needed
- Hysteropexy vs Hysterectomy for Uterine Prolapse: Which Is Better? — a detailed comparison
- How Long Does Uterine Prolapse Surgery Recovery Take? — recovery after hysteropexy
- What Are the Stages of Uterine Prolapse? — which stages suit uterus-preserving repair
- Posterior Colporrhaphy — the wall repair performed alongside hysteropexy
Sources and medical review
- American College of Obstetricians and Gynecologists (ACOG) — practice guidance on pelvic organ prolapse and uterine preservation.
- International Urogynecological Association (IUGA) — patient information on uterine-preserving prolapse surgery.
- Yoon HJ. Perineal plastic surgery (colpoperineoplasty) and female sexual function. Korean Journal of Obstetrics and Gynecology. 2005;48(6).
- Te Linde's Operative Gynecology (textbook) — hysteropexy and apical support procedures.
Next step
A consultation first. A decision only when you are ready.
Tell us what you are experiencing and what you hope to change. Dr. Yoon examines, measures and explains the options, including when no surgery is the right answer. International patients can start with an online consultation before travelling to Seoul.
