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Pelvic Organ Prolapse

Pelvic Organ Prolapse is when weakened pelvic support causes organs (uterus, bladder, etc.) to bulge or slip into the vaginal canal.

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About Pelvic Organ Prolapse

Pelvic Organ Prolapse occurs when the muscles and ligaments that support the pelvic organs weaken, allowing one or more of these organs—such as the uterus, bladder, rectum, or vaginal walls—to slip or bulge into the vaginal canal.

This condition is most commonly seen in women, particularly those who have experienced childbirth, hormonal changes during menopause, or undergone pelvic surgeries.

The most common types of prolapse include:

Uterine Prolapse: where the uterus descends into or outside of the vaginal canal
Vaginal Vault Prolapse: often occurs after a hysterectomy, when the top of the vagina loses support and collapses downward

Other forms include Cystocele (Bladder Prolapse), Rectocele (Rectal Wall Prolapse), and Enterocele (Small Bowel Prolapse).

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Sub-procedures

The Pelvic Organ Prolapse involves possible sub-procedures. To read more about the applicable sub-procedure(s), please read below.

Uterine Prolapse

Uterine Prolapse occurs when pelvic floor muscles and ligaments stretch and weaken, providing inadequate support for the uterus. The uterus then slips down into or protrudes out of the vagina. Uterine prolapse can happen to women of any age, but it often affects postmenopausal women who've had one or more vaginal deliveries. Weakening of the pelvic muscles that leads to uterine prolapse can be caused by:

Damage to supportive tissues during pregnancy and childbirth
Effects of gravity
Loss of estrogen
Repeated straining over the years

If you have mild uterine prolapse, treatment usually is not needed. But if uterine prolapse makes you uncomfortable or disrupts your normal life, you will benefit from treatment. Uterine prolapse varies in severity. You may have mild uterine prolapse and experience no signs or symptoms. If you have moderate to severe uterine prolapse, you may experience:

Sensation of heaviness or pulling in your pelvis
Tissue protruding from your vagina
Urinary problems, such as urine leakage or urine retention
Trouble having a bowel movement
Low back pain
Feeling as if you're sitting on a small ball or as if something is falling out of your vagina
Sexual concerns, such as a sensation of looseness in the tone of your vaginal tissue
Symptoms that are less bothersome in the morning and worsen as the day goes on

Weakening of pelvic muscles and supportive tissues contribute to uterine prolapse. This may happen as a result of:

Pregnancy
Trauma during childbirth
Delivery of a large baby
Difficult labor and delivery
Loss of muscle tone
Less circulating estrogen after menopause

Some conditions — such as obesity, chronic constipation and chronic obstructive pulmonary disease (COPD) — can place a strain on the muscles and connective tissue in your pelvis and may play a role in the development of uterine prolapse. Possible complications of uterine prolapse include:

Ulcers. In severe cases of uterine prolapse, part of the vaginal lining may be displaced by the fallen uterus and protrude outside your body, rubbing on underwear. The friction may lead to vaginal sores (ulcers). In rare cases, the sores could become infected.
Prolapse of other pelvic organs. If you experience uterine prolapse, you might also have prolapse of other pelvic organs, including your bladder and rectum. A prolapsed bladder (cystocele) bulges into the front part of your vagina, which can lead to difficulty in urinating and increased risk of urinary tract infections. Weakness of connective tissue overlying the rectum may result in a prolapsed rectum (rectocele), which may lead to difficulty having bowel movements.

Surgical treatment to repair damaged or weakened pelvic floor tissues is tailored to the type of prolapse and the patient’s needs and may involve:

Vaginal approach (most common): Used to reposition and support the prolapsed organ(s) using sutures, mesh, or native tissue repairs.
Laparoscopic or robotic-assisted approaches: Minimally invasive methods that allow for precise internal repair with smaller incisions, often chosen for uterine or apical prolapse.
Uterine-sparing procedures: For women who wish to retain the uterus, certain surgical options are available that avoid hysterectomy.

Which surgery and surgical approach your doctor recommends depends on your individual needs and circumstances. In all cases, the goal is to restore the normal anatomy and improve function, comfort, and quality of life. If you plan future pregnancies, you might not be a good candidate for surgery to repair uterine prolapse. Pregnancy and delivery of a baby put strain on the supportive tissues of the uterus and can undo the benefits of surgical repair.

Vaginal Vault Prolapse

Vaginal Vault Prolapse occurs when the upper portion of the vagina loses its support and descends toward or beyond the vaginal opening. This condition most commonly affects women who have undergone a hysterectomy (surgical removal of the uterus), as the uterus plays a critical role in maintaining the support structure of the vaginal canal. Once removed, the vaginal vault (the top of the vaginal canal) can weaken and collapse if not properly supported by surrounding ligaments and pelvic floor muscles. The condition results from loss of support to the vaginal apex, often due to:

Previous hysterectomy – the most common risk factor
Pelvic floor muscle weakening, often due to:
- Vaginal childbirth
- Aging and menopause
- Chronic coughing or straining (e.g., constipation)
Obesity, increasing intra-abdominal pressure
Previous pelvic surgeries, which may alter normal support structures
Genetic predisposition to connective tissue weakness

Women with vaginal vault prolapse may present with a range of symptoms depending on the severity:

Sensation of pressure or fullness in the pelvis or vagina
Visible bulge or protrusion of tissue from the vaginal opening
Vaginal spotting or irritation
Urinary symptoms:
- Stress urinary incontinence
- Incomplete bladder emptying
- Increased urinary frequency or urgency
Bowel symptoms:
- Constipation
- Straining with bowel movements
Sexual dysfunction, including discomfort or reduced sensation
Lower back or pelvic pain, especially after prolonged standing

Management depends on the severity and impact on your quality of life. When conservative measures are ineffective or symptoms are severe, surgery may be required to restore support:

Vaginal vault suspension procedures, including:
- Sacrospinous ligament fixation
- Uterosacral ligament suspension
Abdominal or laparoscopic sacrocolpopexy:
- A synthetic mesh is used to attach the vaginal vault to the sacrum
- Considered durable and effective
Minimally invasive techniques are preferred when possible, as they reduce recovery time and complications

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Testimonials

Ilanit Boker

I happily recommend the services of the GMS team. I needed a unique procedure which is not performed in Israel and I turned to them.

Over a telephone conversation with GMS representative Roy, I felt caring attention and confidence that he would help in everything. He accompanied us throughout the entire process, before the flight and even after.

In addition to Roy, we would like to sincerely thank Oriya, our allocated Israeli speaking patient coordinator of the company in Cyprus.

Even before our departure, Oriya was in touch with us helping with any issues and made sure that we arrived fully prepared – taking into account the smallest details; even to the point of finding out our food preferences, and despite the late hour of our arrival at the hotel, she ensured an exquisite meal was waiting for us in the room. Oriya greeted us upon arrival and truly made us feel like we were her personal guests. She accompanied us throughout the entire day of the operation – attentively, with endless care and continued patience.

I felt like I had a good friend with me in the hospital. This kind of treatment doesn’t happen very often… At the end of the day we parted, hugging each other, and Oriya gave recommendations on where to go and what to do in the time remaining before returning home.

I just don’t have enough words to thank GMS and Oriya for everything. I can only recommend with a reassurance that those who need it should use their services.

Almog Brand

When I was looking for information about palm surgery, I found many recommendations about Dr. Amir Oron. After a consultation with Dr. Amir, I was surprised to learn that my health insurance does not guarantee that he will be the surgeon to perform the procedure.

That is when I contacted GMS, who explained how I could have the surgery performed by the physician of my choice – which gave me peace of mind. It is very important for me to share my experience, as the service I received through GMS exceeded any similar experience in Israel: From the beginning I was assigned a GMS representative from Israel, who explained in detail what my experience would be and answered all my questions about the operation and the treatment process. (Thanks, Roy!)

All I had to do was fill out the application form. GMS representatives took care of everything themselves!

They contacted the insurance company on my behalf and even had them check the status of the application until the financial commitment for the surgery was received. We agreed with on the surgical date, booked the flights at a convenient time for me, and also dealt with the hotel reservation. The GMS staff even reviewed the menu and took any dietary restrictions into consideration on my behalf.

We were picked up from the airport in Larnaca, Cyprus where we met the wonderful Oria, who accompanied us throughout the entire visit and took care of every detail; from registration to preparation for the operation.

This is essentially a VIP service that made the entire experience relaxed and stress-free.
The assigned coordinators continued caring after my return to Israel. They were interested in my recuperation post-operatively and also ensured all financial matters were dealt with; all this, by the way, without any commissions or payouts on my part, but directly with my insurance.
In a word – an amazing experience!
In short – I recommend it!

Thank to GMS, thank you Roy, thank you Uriah and thank you Dr. Oron.

Nirit Shortz-Raphael

I do not even know where to start!!
Overall, the service exceeded all my expectations!

Roy – thank you for your patience, quick responses (minutes!), availability, caring and clear explanations! You are inimitable! Oriya – you are amazing! Thank you for every smile, hug, help, guidance, explanation… really! You are simply amazing!

Every time I was asked by friends and family about the surgery, I immediately started talking about your amazing service! I felt warmth and love, and everyone who was with me felt the same!
We never stop talking about you, and really, only good things!

You have entered our hearts!
Thank you very much for everything! I hope to see you in the future, under different circumstances.

Nadav Ben-Ezer

When one thinks of “Medical Operation” overseas, the last thing that comes to mind is a “Great Experience”, but this is exactly what I have experienced, going through a prostate removal procedure via GMS Cyprus. With their professional and compassionate approach, the GMS Cyprus team provides to the confused and worried patient a complete transparent VIP envelop, which takes care of all the logistics involved in “Medical Tourism” for the patient and their escort, as well as assembling a world class international medical team and medical facilities suitable to treat the medical diagnosis at hand.

From the first time the medical situation was diagnosed, and the first contact was made, the GMS team was there to remove the hassle and understand my concerns and worries about the medical issue and being far from home, and they handled every detail of the logistics of travel, insurance company requirements and medical preparations. From first arrival at the luxurious hotel, assigned to the first night and for my personal escort, the GMS management, Udi and Clair, has treated me as family away from home and personally came to greet me and attend firsthand to all my needs and requests. To top it all, they assigned their own personal escort, the wonderful Aia, which was available 24/7 and door to door to handle any need and detail and helped interface with the local hospital team.

I want also to recommend the choice of the hospital at Limassol, which is modern and clean, and of course GMS team have in advance reserved a private and spacious room and nominated a local doctor, which was familiar with my case and participated in the treatment and which came often to check my condition and parameters.

To summarize, I would not go so far as to wish such treatment to anybody, but if you must go through the medical procedure, the VIP treatment provided by GMS is a legitimate alternative, combining easy logistics, professional medical treatment by your own doctor, modern hospital, relaxed overseas experience and personal compassionate escorting to ease and sweeten the experience.

Dorit

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