Pelvic Organ Prolapse · Patient guide
Do I Need a Hysterectomy for Uterine Prolapse?
No, most women do not need a hysterectomy for uterine prolapse. The uterus drops because the ligaments and pelvic floor beneath it have weakened, and those supports can be repaired with the uterus left in place through a hysteropexy. At Somssi Women's Clinic in Gangnam, Seoul, Dr. Yoon Ho-joo performs uterus-preserving native-tissue repair as standard, reserving hysterectomy for uterine disease, patient preference or advanced prolapse needing hospital surgery.
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: usually not; hysteropexy repairs the support and keeps the uterus
- When hysterectomy is reasonable: uterine cancer or precancer, troublesome fibroids or bleeding, personal preference, some stage 3 to 4 cases treated in hospital
- Somssi's standard operation: hysteropexy, culdoplasty, posterior colporrhaphy and pelvic floor restoration with your own tissue, no mesh
- Clinic data: in a 2026 series of 150 women with prolapse, the clinic reported 74.7% chose uterus-preserving surgery
- Procedure time and stay: about 1 hour; same-day discharge
- Intercourse after surgery: 7 to 8 weeks
Most women with uterine prolapse do not need a hysterectomy. Prolapse is a support problem, not a uterus problem, and the support can be rebuilt while the uterus stays in place. Removing the uterus is appropriate for some women, but it is a choice to be made with full information rather than an automatic step.
Why the uterus is not the problem
The uterus sits at the top of the vagina, held by the uterosacral and cardinal ligaments and resting on the pelvic floor muscles. Childbirth, aging, menopause, chronic straining and genetics stretch these supports, and the uterus descends because nothing is holding it up. Taking the uterus away removes the organ that dropped, but it does not restore the ligaments or muscles, and the top of the vagina can later drop in the same way, a problem called vault prolapse.
Somssi Women's Clinic is a surgical gynecology clinic in Gangnam, Seoul, founded in 2000 and led by Dr. Yoon Ho-joo, MD, PhD. In our experience many women arrive having been told that hysterectomy is the only option, when in fact a uterus-preserving repair was available to them.
What a uterus-preserving repair involves
The alternative to hysterectomy is a hysteropexy: the uterus is repositioned and the tissue around the cervix is gathered and tied to hold it, lifting it by roughly 2 to 4 centimeters in the clinic's experience. The cul-de-sac behind the cervix is closed (culdoplasty) so bowel cannot push down later. Because prolapse almost always comes with a weakened back wall and perineum, Dr. Yoon combines this with a posterior colporrhaphy and pelvic floor restoration using two-layer suturing of your own tissue, without mesh. Surgery takes about an hour under sedation and you go home the same day. Full details are on the uterine prolapse surgery page.
Hysterectomy versus hysteropexy at a glance
| Consideration | Hysterectomy for prolapse | Hysteropexy (uterus kept) |
|---|---|---|
| What is removed | The uterus, usually with the cervix | Nothing; the uterus is re-suspended |
| Fixes the support defect? | Only if combined with a vault suspension | Yes, the support itself is rebuilt |
| Fertility | Ended | Preserved, though later vaginal birth may stress the repair |
| Hospital stay | Usually 1 to several days | Same-day discharge at the clinic |
| Future uterine problems | None possible | Screening continues as normal |
| Recurrence | Possible (vault prolapse) | Possible; depends on tissue and lifestyle |
Large comparative studies suggest both approaches give similar prolapse control in the medium term when done well, so the decision often rests on your preferences and on whether the uterus itself is healthy. Our guide Hysteropexy vs Hysterectomy for Uterine Prolapse goes deeper.
When hysterectomy is the right choice
- Uterine disease: cancer or precancerous changes of the uterus or cervix, large or symptomatic fibroids, adenomyosis with heavy bleeding, or abnormal bleeding that has not responded to treatment.
- Personal preference: some women past childbearing simply prefer removal and the end of periods or screening worries; that is legitimate.
- Advanced prolapse: stage 3 to 4 prolapse, where the cervix reaches or protrudes beyond the opening, often needs a hospital-based operation, which may include hysterectomy with a vault suspension. Dr. Yoon will tell you honestly if this applies.
- Failed previous hysteropexy in some circumstances.
Even then, a hysterectomy done for prolapse should always be paired with a proper suspension of the vaginal top and repair of the vaginal walls, or the prolapse is likely to return.
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 was recognized at the Korean Society for Sexual Medicine meeting in May 2026. These are the clinic's own figures, not an independent trial, but they reflect how often the uterus can be kept when the option is offered. Dr. Yoon's research on sexual function after pelvic floor repair, including his 2005 paper in the Korean Journal of Obstetrics and Gynecology, also informs the preference for keeping anatomy intact where possible.
Questions to ask before agreeing to a hysterectomy
- Is there a problem with my uterus itself, or only with its support?
- What stage is my prolapse, and would a hysteropexy be possible at this stage?
- If the uterus is removed, how will the top of the vagina be supported?
- Will the rectocele, perineum and vaginal wall be repaired at the same time?
- What are the recurrence rates with each option in your hands?
A second opinion is reasonable for any major surgery. We review records sent through our contact page before you travel, and our guide for international patients explains how a visit works.
Bottom line
Uterine prolapse is usually treated without removing the uterus. A hysteropexy with native-tissue repair of the vaginal walls restores the support that actually failed, keeps your anatomy intact and is done with same-day discharge at Somssi. Hysterectomy remains the right choice for uterine disease, personal preference or advanced prolapse that needs hospital surgery, and an honest examination will tell you which group you are in.
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 keeping the uterus riskier for prolapse coming back?
Not in itself. Recurrence depends mainly on tissue quality, the stage of prolapse, how thoroughly the support was rebuilt and lifestyle factors such as straining and lifting. Comparative studies show similar medium-term results for hysteropexy and hysterectomy with suspension. What matters is that the support defect, not just the organ, is addressed.
Can I keep my uterus if I am past menopause?
Yes. Age is not a reason to remove a healthy uterus. Many women in their 50s, 60s and 70s have a hysteropexy. After menopause we may use vaginal estrogen before surgery to improve tissue quality, and routine cervical screening continues as usual afterward.
Will I still need Pap smears after a hysteropexy?
Yes, because the cervix remains. Screening continues on the normal schedule for your age. We check the cervix at your pre-operative visit and can perform the smear at the same time if one is due.
What if I have fibroids as well as prolapse?
Small, symptom-free fibroids do not require hysterectomy and the uterus can still be suspended. Large or symptomatic fibroids may be treated separately; the clinic offers HIFU for suitable fibroids and adenomyosis. If bleeding or fibroid symptoms are severe, hysterectomy with vault suspension may be the better single operation, and we discuss that openly.
Does a hysterectomy affect sexual function?
For most women sexual function after hysterectomy is similar or improved once prolapse symptoms are gone, but some report changes in sensation, and the cervix is lost. Keeping the uterus avoids that question entirely. Dr. Yoon's research focuses on sexual function after pelvic floor surgery, and we discuss expectations frankly.
How do I find out which option suits me?
An examination with POP-Q staging, measurement of vaginal length and wall thickness, and a pelvic ultrasound of the uterus and ovaries answers most of the question in one visit. Bring any previous reports. We give you a written plan with both options explained.
Keep reading
Related treatments and guides
- Uterine Prolapse Surgery — the uterus-preserving operation in detail
- Hysteropexy vs Hysterectomy for Uterine Prolapse: Which Is Better? — a fuller comparison
- Can Uterine Prolapse Surgery Be Done Without Removing the Uterus? — how hysteropexy works
- What Are the Stages of Uterine Prolapse? — why stage affects the choice
- Can Uterine Prolapse Come Back After Surgery? — recurrence with either approach
- Fibroid Treatment — if fibroids are part of the decision
Sources and medical review
- American College of Obstetricians and Gynecologists (ACOG) — practice guidance on pelvic organ prolapse, including uterine preservation.
- International Urogynecological Association (IUGA) — patient information on surgery for uterine prolapse.
- 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) — uterine-preserving and hysterectomy-based prolapse 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.
