Assistant Professor Dr. Soner Gök from PAU Hospitals Gynecology and Obstetrics Department stated: “Uterine prolapse, medically referred to as uterine prolapsus, is a frequently encountered but unfortunately rarely discussed issue in women’s health. It is especially common in women who have given birth and in those entering menopause, and it can significantly affect quality of life. As a specialist in Gynecology and Obstetrics, I want to share the causes, symptoms, diagnosis, and treatment methods of uterine prolapse. Our goal is to encourage women to become aware of these issues and seek solutions rather than silently enduring them. Uterine prolapse occurs when the uterus descends from its normal anatomical position toward the vagina due to weakening of the pelvic floor muscles and connective tissues. Initially mild, this condition can progress over time and, in advanced stages, lead to the uterus protruding completely outside the vagina. This is not only a physical discomfort; it can also negatively impact sexual life, urinary and bowel function, and cause psychological loss of self-confidence. Women often delay seeking help due to embarrassment, although early diagnosis and appropriate treatment can yield successful results.

There are many causes of uterine prolapse. Key factors include multiple vaginal deliveries, especially complicated ones that may cause permanent weakening of pelvic muscles. Menopause-related estrogen decline reduces the elasticity of connective tissues. Genetic predisposition also plays a role; women with a family history of uterine prolapse are at higher risk. Long-term heavy physical labor, chronic lifting, persistent constipation, or coughing that increases intra-abdominal pressure can also contribute. Excess weight, i.e., obesity, increases pressure on the pelvic floor and accelerates prolapse. Patients typically present with a feeling of fullness in the vagina, downward pressure, or a protruding mass. These symptoms worsen with prolonged standing or physical exertion. Pain during intercourse, urinary incontinence, frequent urination, difficulty urinating, and constipation may also accompany the condition, significantly affecting daily and social life.”

Assistant Professor Dr. Soner Gök:“If you feel fullness or pressure in the vaginal area, consult a specialist without delay.”

Dr. Gök explained that diagnosis is often made with a simple gynecological examination, but advanced imaging methods such as ultrasound or dynamic MRI may be used for more detailed assessment of pelvic organs. He added: “If there are urinary problems, urodynamic testing is performed to evaluate pelvic floor function. Treatment decisions consider the degree of prolapse, patient age, overall health, sexual activity, and desire for future fertility. Mild prolapse can benefit from Kegel exercises to strengthen pelvic floor muscles. Vaginal pessaries (supportive rings inserted into the vagina) can be used for patients who cannot or do not wish to undergo surgery, especially suitable for elderly patients or those with surgical risk. Advanced cases require surgical treatment. The most commonly preferred method is vaginal hysterectomy with simultaneous correction of accompanying bladder or bowel prolapse. This method does not require abdominal incision, allowing faster recovery, but it ends fertility.”

Assistant Professor Dr. Soner Gök: “For patients wishing to preserve the uterus or planning future pregnancy, laparoscopic (minimally invasive) or robotic sacrohysteropexy (supporting the uterus by attaching it to the sacrum) methods can keep the uterus in place and anchored to the sacrum, preserving anatomy while providing aesthetic and functional results. Other uterus-preserving surgical options include uterosacral ligament fixation (strengthening supporting ligaments) and the Manchester procedure. In elderly patients with no sexual activity and unsuitable for major surgery, LeFort colpocleisis (closure of the vaginal entrance) can be performed. This method is quick and low-risk but prevents sexual intercourse. Recovery after surgery typically takes 4–6 weeks; heavy lifting, constipation-inducing foods, and sexual activity should be avoided. Surgery duration ranges from 1–3 hours depending on the method, with hospital stays usually 1–2 days. Surgery is highly successful, but prolapse may recur if habits that strain the pelvic floor continue. Therefore, adopting healthy lifestyle habits, weight management, regular exercise, and preventing constipation are crucial.

If left untreated, uterine prolapse can progress and lead to urinary and bowel problems, vaginal ulcers, sexual dysfunction, and recurrent infections. Psychological effects may also negatively impact a woman’s self-confidence and social life. Therefore, women noticing fullness, pressure, or a mass in the vaginal area should consult a gynecologist promptly without embarrassment. Uterine prolapse is common and treatable, not a source of shame. Early diagnosis and appropriate treatment planning can restore quality of life. For a healthy and independent life, listen to your body and do not neglect these symptoms.”