Do I Need to Have a Hysterectomy if I have Prolapse?

Whether or not a hysterectomy is recommended at the time of prolapse repair depends on each patient’s symptoms and physical exam. If the exam reveals bulging of the bladder (cystocele) or rectum (rectocele) but the uterus is not significantly prolapsed, a vaginal prolapse repair may be the best treatment option. During this type of vaginal prolapse repair, the cervix/uterus is elevated, but not removed. If there is significant prolapse of the uterus, a partial hysterectomy combined with a da Vinci sacocolpopexy may be recommended. More advanced or complete uterine prolapse may require a vaginal hysterectomy at the time of surgical repair. Additional factors are taken into consideration when deciding if proceeding with a hysterectomy is right for each patient. These considerations include painful, heavy periods, fibroids, abnormal pap smears and if the patient is seeking future pregnancies. In cases with uterine prolapse when the patient is seeking future pregnancies it may be possible to preserve the uterus.

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