Surgery treats uterine prolapse by restoring the support that the vagina had before the prolapse occurred. There are typically three types of damage to the supportive structures of the vaginal wall. There can be generalized weakening or stretching of the support, a tear or hole in the support, or one of the areas where the support attaches can be broken. Like a hammock, it can be stretched out, have a hole in it, or one of the tethers that holds it up can break.
These repairs can be performed using the woman’s tissue to repair tissue. This has the advantage that the woman very rarely rejects herself. However, it tends to have a little more discomfort initially and because it has failed once may have higher rates of recurrence/failure. The support can be augmented with collagen or a synthetic mesh. These materials do provide more strength and may lower recurrence rates, but may increase other complications. Some doctors perform repairs using the woman’s tissue to repair her tissue and only use other materials for recurrent prolapse or more extreme cases.
Side effects of surgery for uterine prolapse may include short term spotting and discomfort with sitting. There may be a little higher rate of vaginal infection or urinary tract infections. Limitations after surgery typically include no intimacy for six weeks and no heavy lifting (more than 10 pounds) for six weeks. Long term, the vagina can be given too much support. This may result in some painful intercourse. Typically, this resolves with time and there are treatments to speed up the return to normal sexual function.
