Pelvic Organ Prolapse · Treatment

Pelvic Reconstructive Surgery: Native-Tissue Repair in Seoul

Pelvic reconstructive surgery rebuilds the structures that support the uterus, vagina, bladder and rectum after childbirth, aging or earlier surgery has weakened them. At Somssi Women's Clinic in Gangnam, Seoul, Dr. Yoon Ho-joo reconstructs in a set order: uterine position first, then the pelvic floor muscles, then the vaginal wall with two-layer suturing, then the perineum, using only your own tissue and no mesh. Most cases take 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.

• What is rebuilt: uterine support (hysteropexy, culdoplasty), pelvic floor muscles, posterior vaginal wall, perineum
• Materials: 100% your own tissue; no mesh, bands or implants
• Procedure time: about 50 minutes to 1 hour
• Anesthesia: sedation plus long-acting local; local only on request
• Hospital stay: none; same-day discharge after urinating
• Sutures: absorbable, dissolve in about 1 week
• Intercourse: after 7 to 8 weeks

What is pelvic reconstructive surgery?

Pelvic reconstructive surgery is the umbrella term for operations that restore the anatomy and function of the female pelvic floor. It covers repair of pelvic organ prolapse (uterus, bladder, rectum, bowel or vaginal vault), repair of a lax or torn vaginal wall, rebuilding of a perineum damaged by childbirth, and correction of problems left by earlier surgery or implants. The word "reconstructive" matters: the aim is not to remove organs but to put the support system back together.

Somssi Women's Clinic is a surgical gynecology clinic in Gangnam, Seoul, founded in 2000 and led by Dr. Yoon Ho-joo, MD, PhD, a member of the Korean Society of Urogynecology. Our form of pelvic reconstruction is vaginal, uterus-preserving and native-tissue: we use your own fascia, muscle and mucosa, and we do not implant mesh.

Who is a good candidate?

• Uterine prolapse (cervix descended into the vagina), with or without a rectocele or enterocele.
• Vaginal laxity after childbirth: a wide canal, air trapping, reduced sensation, pooled secretions with odor or recurrent vaginitis.
• A shortened or scarred perineum from tears or episiotomy, with a gaping opening.
• Feeling that the "bottom is falling out", low back ache or lower-abdominal heaviness that eases when lying down.
• Urinary frequency, incomplete emptying or constipation that began with the prolapse.
• Problems after surgery elsewhere: an opening narrowed to a painful "chin" while the inside stays loose, exposed or painful implants, or a repair that simply did not hold.

Reconstruction is usually a once-in-a-lifetime operation, so we take time at consultation to confirm the diagnosis and rule out other causes of your symptoms. Our guide What Surgery Is Used for Pelvic Organ Prolapse? compares the main operations.

How Somssi performs pelvic reconstructive surgery

Assessment first

Reconstruction starts with measurement. Dr. Yoon records total vaginal length (normally 8 to 9 centimeters), the distance the cervix has descended, the thickness of the vaginal wall (a lax posterior wall can thin to 2 to 3 millimeters near the cervix), and the contraction pressure of the pelvic floor. A pelvic ultrasound checks the uterus, ovaries and tubes, and we screen for stress incontinence and overactive bladder. Photographs are taken for comparison afterward.

Step 1: restore uterine position

If the uterus has dropped, it is repositioned and the supporting tissue around the cervix is gathered and tied (hysteropexy), lifting it by roughly 2 to 4 centimeters in the clinic's experience. The cul-de-sac behind the cervix is closed with a culdoplasty so bowel cannot push down later. Keeping the uterus keeps the natural anchor at the top of the vagina; the details are on the uterine prolapse surgery page.

Step 2: restore the pelvic floor muscles

Through the posterior wall, starting at the posterior fornix in front of the cervix and working toward the opening, the mucosa is peeled to under 1 millimeter with fine ophthalmic scissors rather than cut. The levator and sphincter muscles beneath are gathered toward the midline and sutured, rebuilding a muscular layer that can contract again. This is the step Kegel exercises cannot replace once the muscle has thinned.

Step 3: rebuild the vaginal wall with two-layer suturing

The peeled mucosa is folded over the repaired muscle and closed with a second, fusiform suture line, creating a thick, ridged posterior wall about 2 to 3 centimeters deep. Suturing from inside outward and in two layers is designed to stop the repair stretching back. The anterior wall, which carries the urethra and bladder, is left untouched to protect sensation and continence.

Step 4: reconstruct the perineum and opening

At the opening, a figure-8 suture strengthens the pubococcygeus muscles and the perineal body is rebuilt so the distance between vagina and anus is restored. If an earlier operation left the opening too tight, it is released at the same time so the canal has a consistent width from cervix to hymen. Our perineoplasty and perineal scar revision pages cover this stage.

Revision cases

Women who had implant-based or filler-based surgery elsewhere are seen through the clinic's revision program: foreign material is removed where it is accessible, and the tissue is reconstructed in the same way. Complex mesh complications involving the bladder or bowel are coordinated with hospital partners; see Vaginal Mesh Complication Revision.

Anesthesia, duration and hospital stay

A full reconstruction takes about 50 minutes to one hour. We use sedation so you have no memory of the procedure, combined with a mixture of three long-acting local anesthetics for comfort afterward. Local anesthesia alone is an option, and a non-opioid anti-inflammatory is injected at the end.

No hospital admission is needed. You walk shortly after waking and go home once you have urinated. Fast for two hours before your appointment, wear loose clothing and remove nail polish.

Recovery timeline

Between zero and five short follow-up treatments may be advised depending on symptoms. Patients from abroad manage aftercare at home and stay in touch with us by message or video.

Results and what to expect

The target is a vagina of normal length, width and direction with a contractile posterior wall, a uterus that stays in place, and a perineum that closes the opening. Most women report the heaviness is gone within days and that emptying the bowel and bladder becomes easier. In the clinic's experience the thicker wall also improves vaginal acidity and reduces recurrent vaginitis, although this has not been tested in an independent trial.

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. Dr. Yoon's 2005 paper in the Korean Journal of Obstetrics and Gynecology, and his ISSWSH 2008 presentation on pelvic floor dysfunction and posterior colpoperineorrhaphy, examined sexual function after this kind of repair. Results vary from woman to woman.

Risks and how we reduce them

• Bleeding and infection: reduced by shallow dissection and antibiotics; call us for heavy bleeding, fever or foul discharge.
• Rectal or cul-de-sac injury: inherent risks of posterior repair; we work with fine instruments at under 1 millimeter depth and would repair an injury immediately.
• Over-correction, pain with intercourse or a shortened vagina: we size the canal to the cervix, preserve mucosa rather than excise it and never shorten the vagina, since a short vagina is more likely to prolapse again.
• Reduced sensation or dryness: avoided by leaving the anterior wall alone and by peeling rather than cutting the mucosa and muscle.
• Wound separation, suture granulation, scarring: uncommon and usually managed with local care.
• Recurrence: possible with chronic straining, heavy lifting, obesity, smoking or weak connective tissue; see Can Pelvic Organ Prolapse Come Back After Surgery?.
• Anesthesia reactions: rare with sedation; you are monitored throughout.

Stage 3 to 4 prolapse, large cystoceles and significant stress incontinence may need a hospital-based operation, sometimes with hysterectomy or a sling. Dr. Yoon will tell you honestly if you fall into that group and coordinate with hospital partners.

Why international patients choose Somssi

English-language consultation, a Ministry of Health and Welfare foreign-patient registration since 2011 and Seoul Medical Tourism cooperation status since 2016 make the process straightforward. The clinic is 100 meters from Gangnam Station Exit 1, surgery is same-day, and dissolvable sutures mean nothing needs removing before you fly.

Dr. Yoon has practiced since 2000 and has published and presented on pelvic floor surgery and sexual function in Korea and internationally. See international patients for planning details or contact us with your history for a preliminary opinion.

Questions patients ask

Frequently asked questions

Short, honest answers. For anything personal, a consultation is the right place to ask.

See the full FAQ →

Is pelvic reconstructive surgery the same as vaginoplasty?

They overlap. A full reconstruction includes the posterior vaginoplasty (tightening of the back wall) but adds uterine suspension, culdoplasty, pelvic muscle repair and perineal reconstruction. Vaginoplasty alone addresses laxity; reconstruction addresses prolapse and the support structures as a whole. Dr. Yoon decides which components you need after measuring.

Why do you repair the uterus position before the vaginal wall?

Because the vagina hangs from the uterus and cervix. Tightening the wall while the uterus still sits low leaves a short, kinked canal that tends to prolapse again. Restoring apical support first and then rebuilding the muscle and wall beneath it follows the textbook principle that a shortened vagina is more likely to fail.

Can reconstruction be done if I have had a hysterectomy?

Yes, with adjustments. There is no uterus to suspend, so support at the top relies on culdoplasty and the repaired posterior wall. If the vaginal vault itself has dropped significantly, a hospital-based suspension may be the better option, and we will say so after examining you.

Does the surgery help back pain and constipation?

Many women notice both improve, because a descended uterus and a rectocele pull on ligaments and trap stool. We cannot guarantee relief, since back pain has many causes, but prolapse-related heaviness and straining typically ease once support is restored.

What happens to the stitches?

All sutures are absorbable and have largely dissolved by one week. There is no removal visit, which is why patients from other cities and countries can finish recovery at home. You may notice small fragments in discharge; that is normal.

How is this different from a mesh repair?

Mesh repairs add a synthetic scaffold; native-tissue reconstruction rebuilds your own layers. Mesh can give durable support but has a known risk of exposure and pain, which led the US FDA to halt transvaginal prolapse mesh in 2019. Native tissue avoids that risk but depends on your tissue quality, which we assess before recommending surgery.

Keep reading

Related treatments and guides

• What Surgery Is Used for Pelvic Organ Prolapse? — the main operations compared
• Hysteropexy vs Hysterectomy for Uterine Prolapse: Which Is Better? — the uterus-preserving choice explained
• How Long Does Pelvic Organ Prolapse Surgery Recovery Take? — what recovery looks like
• Pelvic Organ Prolapse Treatment in Korea for Foreigners: Complete Guide — logistics for overseas patients
• Pelvic Organ Prolapse Repair — compartment-by-compartment repair
• Native Tissue Vaginal Surgery — why we use your own tissue
• Dr. Yoon Ho-joo — your surgeon's training and research

Sources and medical review

• 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) — principles of pelvic reconstructive surgery and vaginal support.
• International Urogynecological Association (IUGA) — patient information on pelvic organ prolapse surgery.
• US Food and Drug Administration (FDA) — 2019 action on surgical mesh for transvaginal prolapse repair.

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.