Prolapse: Do I Have to Lose My Uterus? Your Options Explained

You were told the womb has dropped, and the first thing you thought was: will they take my uterus out? Many women carry this fear quietly, often before they have even been examined. The honest answer is that it depends on what the examination finds.

Prolapse means the uterus, bladder or bowel has slipped down from where the pelvic tissues normally hold it. It is common, especially after childbirth and around the menopause, and it is not something you simply have to endure. Having a prolapse does not mean the uterus has to come out.

Surgery is not the first step for everyone. For mild to moderate prolapse, pelvic floor training and a vaginal pessary are options that do not involve an operation. Many women with bladder leakage also start without surgery. The first step is an assessment, so that the choice is based on what is actually happening in your pelvis.

If surgery is discussed, there are two broad routes: repairing the support and leaving the uterus in place, or removing the uterus as part of the repair. Keeping the uterus is a real option for many women, particularly if you wish to keep it or may want a pregnancy. Removal may be advised when there is unexplained bleeding, fibroids, an abnormal screening result, or a prolapse where the tissue cannot hold a repair. Keeping the uterus also means you still need cervical screening, and prolapse can come back after any repair. Whether the ovaries stay is a separate decision from whether the uterus does.

Another common worry is the scar. Most prolapse surgery, including removal of the uterus, is done through the vagina, so there is no abdominal wound and no external scar. Sometimes a keyhole or abdominal route is chosen for a specific reason, and your doctor will tell you why. Surgery is not done at the clinic. It is arranged at Praram 9 Hospital or Vimut Hospital, while assessment and follow-up stay with the clinic. How long recovery takes differs between people and operations, so it is explained after you have been examined, not before.

Results differ between individuals, and no outcome is guaranteed. What an assessment gives you is the chance to ask every question, including whether the uterus can stay, and to decide at your own pace. See a doctor sooner if you have a bulge you cannot push back, difficulty passing urine, bleeding after the menopause or between periods, pain, or a fever. Anyone who tells you which operation you need without examining you is guessing.