Could you have a post-hysterectomy prolapse?

Nearly 50,000 women in the UK each year find themselves going through hysterectomy surgery for any number of reasons, from cancers to chronic conditions and much more besides. It’s a traumatic procedure for anyone to go through both mentally and physically, but a small number of those women also go on to suffer from genitourinary prolapse as a result.

This uncomfortable condition comes about when one or more organs in the pelvic cavity slip out of place due to surgery weakening the support systems of the organs, ligaments and pelvic floor muscles. Bowel takes over the space of where the uterus was and can also push on the vagina causing prolapse.

There are three main types of prolapse; Anterior Compartment Prolapse is the prolapse of the urethra into the vagina, the prolapse of the bladder into the vagina or the prolapse of both the urethra and the bladder. Middle Compartment Prolapse involves the vaginal vault prolapsing into the vagina and Posterior Compartment Prolapse which involves the rectum falling into the vagina.

It’s possible for post-hysterectomy prolapse to be almost asymptomatic, but there are a few things to look out for, and if you have one or more of the symptoms after a hysterectomy it’s worth visiting your doctor. The most commonly reported symptoms are a feeling of pressure, also described as a fullness or heaviness, a bulge or protrusion, being unable to retain tampons and spotting.

Symptoms relating to the bladder such as incontinence and frequent urination should also warrant a visit to your GP, while bowel symptoms and problems with sex can also indicate problems.

Don’t worry if it all sounds all too familiar – treatment options vary according to the severity of the prolapse and could be as non-invasive as lifestyle changes like losing weight and stopping smoking. Vaginal pessaries can be used to lift the walls of the vagina, or for a more permanent solution, there are prolapse surgery options available.

Mr Broome is a highly qualified gynaecological surgeon with a lot of experience carrying out vaginal repair operations including Sacrocolpopexy, in which the vagina is elevated and fixed into the sacrum with mesh and Sacrospinous fixation, in which the vagina is stitched to a ligament inside the pelvis, requiring no entry through the abdomen.


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