Assoc. Prof. Dr. Pınar Kadiroğulları
Assoc. Prof. Dr. Pınar Kadiroğulları is a specialist in obstetrics and gynecology. She specializes particularly in HPV treatment and cervical cancer prevention, providing holistic healthcare to her patients in the areas of pregnancy monitoring, genital aesthetics, and gynecological surgery.
By combining her academic background with clinical experience, she offers every patient an evidence-based, personalized treatment approach.
Pelvic organ prolapse treatment requires a personalized approach to address a health issue that significantly affects women’s quality of life yet is often overlooked. In Türkiye, approximately 40% of women over the age of 50 have some degree of pelvic organ prolapse; however, only one-third of these patients consult a physician.
In modern urogynecology practice, a personalized treatment plan is developed in line with the guidelines of the IUGA (International Urogynecological Association) and the EAU (European Association of Urology), taking into account the type and degree of prolapse as well as the patient’s lifestyle. With her experience in genital prolapse and laparoscopic surgery at her clinic in Nişantaşı, Istanbul, Assoc. Prof. Dr. Pınar Kadiroğulları offers a holistic approach to pelvic floor health.
Information Note
Pelvic organ prolapse is not “a natural consequence of aging” and is a condition that can definitely be treated. With early intervention, recovery can be achieved in most patients through non-surgical methods. You can also visit our Urinary Incontinence Treatment page →
What Is Pelvic Organ Prolapse?
Pelvic organ prolapse is a condition in which pelvic organs—such as the bladder, uterus, vaginal walls, or rectum—descend from their normal position as a result of weakening of the muscles and connective tissue supporting the pelvic floor. It is one of the most common pelvic floor disorders in women, and its prevalence increases particularly after childbirth and during menopause.
This condition typically develops due to factors that strain the pelvic floor, such as birth trauma, advanced age, hormonal changes, chronic constipation, or heavy lifting. The main objectives of pelvic organ prolapse treatment are as follows:
1. Determining the Type and Degree of Prolapse: The type and stage of prolapse are identified through a detailed pelvic examination using the POP-Q classification system.
2. Improving Quality of Life: Restoring sexual life, urinary, and bowel function.
3. Long-Term Solution: Strengthening the pelvic floor muscles or, when necessary, achieving a lasting cure through laparoscopic / minimally invasive surgery.
Important Information
Pelvic organ prolapse is much easier to treat when diagnosed early. In mild-stage prolapse, non-surgical methods are highly successful. In advanced stages, modern minimally invasive surgical techniques such as laparoscopic sacrocolpopexy achieve success rates exceeding 90%.
Types and Symptoms of Pelvic Organ Prolapse
Pelvic organ prolapse treatment is planned according to the type of prolapsed organ and the degree of prolapse. In clinical practice, there are four main types of prolapse, each presenting with different symptoms.
1. Cystocele (Bladder Prolapse)
- The bladder descends onto the anterior vaginal wall
- The most common type — accounting for over 50% of pelvic organ prolapses
- Difficulty urinating and a sensation of incomplete bladder emptying
- Recurrent urinary tract infections
- Often accompanied by stress urinary incontinence
2. Rectocele (Rectal Prolapse)
- The rectum descends onto the posterior vaginal wall
- Constipation and difficulty with bowel movements
- A sensation of incomplete bowel emptying
- Manual pressure on the vaginal area may sometimes be needed
- Discomfort during sexual intercourse
3. Uterine Prolapse
- The uterus descends into the vaginal canal
- A sensation of pressure and fullness in the pelvic area
- Feeling or seeing a mass in the vagina
- Lower back pain, particularly toward the end of the day
- In advanced stages, the cervix may protrude outside the vagina
4. Vaginal Vault Prolapse
- Occurs in patients who have previously undergone hysterectomy
- Downward descent of the vaginal vault
- Requires surgical treatment
- Generally seen in advanced age
Doctor’s Advice
Prolapse can often occur in more than one area at the same time. For example, a cystocele may coexist with a rectocele or uterine prolapse. For this reason, a detailed pelvic examination and POP-Q staging are critically important for an accurate treatment plan.
Pelvic Organ Prolapse Treatment Methods
Pelvic organ prolapse treatment is planned through a stepwise approach, based on the degree of prolapse (POP-Q stage), the patient’s age, overall health condition, and future pregnancy plans. For mild-stage prolapse, non-surgical methods are preferred as the first-line treatment.
First-Line Treatment
Conservative (Non-Surgical) Treatment
- Pelvic Floor Exercises (Kegel): Strengthening of the supporting tissues through regular contraction-relaxation training.
- Pessary Use: A silicone support ring placed in the vagina to hold the organs in place.
- Lifestyle Modifications: Weight control, treatment of constipation, and avoidance of heavy lifting.
- Local Estrogen Therapy: Strengthening of the vaginal tissues during the postmenopausal period.
Second-Line Treatment
Vaginal Surgical Treatment
- Anterior Colporrhaphy: Vaginal repair of bladder prolapse for cystocele.
- Posterior Colporrhaphy: Reinforcement of the posterior vaginal wall for rectocele repair.
- Vaginal Hysterectomy: Removal of the uterus through the vaginal route in cases of uterine prolapse.
- Sacrospinous Fixation: Suspension of the vaginal vault or uterus to the pelvic ligaments.
Third-Line Treatment
Laparoscopic Minimally Invasive Surgery
- Laparoscopic Sacrocolpopexy: Considered the gold standard, this procedure involves attaching the vagina to the sacrum using synthetic mesh.
- Laparoscopic Pectopexy: A modern alternative technique preferred in sexually active women.
- Laparoscopic Hysteropexy: A uterine suspension procedure that preserves the uterus.
- Advantages: Less pain, faster recovery, small incision scars, and a 95% success rate.
Prevention and Lifestyle Recommendations
During the pelvic organ prolapse treatment process, lifestyle adjustments play a critical role both in preventing the progression of existing prolapse and in maintaining lasting results after treatment. The following recommendations are evidence-based suggestions from the IUGA and ICS.
Recommendations for Daily Life
- Healthy weight control: Aim to keep your BMI below 25.
- Regular Kegel exercises: Perform 3 sets per day, with 10 repetitions in each set.
- Reduce heavy lifting: Avoid carrying loads over 5 kg.
- Proper lifting technique: Lift by bending your knees and keeping your back straight.
- Prevent constipation: Maintain a fiber-rich diet and drink 1.5-2 L of water per day.
- Treat chronic coughing: Quit smoking and keep allergies under control.
Postpartum Prevention
- Begin Kegel exercises 6 weeks after delivery.
- Avoid heavy lifting during the first 3 months.
- Take advantage of pelvic floor physiotherapy.
- Do not neglect regular gynecological check-ups.
⚠️ When to Consult a Physician
- A sensation of pressure or fullness in the pelvic area
- Feeling or seeing a mass in the vagina
- Difficulty urinating or holding urine
- Constipation and difficulty with bowel movements
- Discomfort or pain during sexual intercourse
- Lower back pain (particularly worsening toward the end of the day)
Important Reminder
Pelvic organ prolapse is not a permanent fate but a treatable condition. With early diagnosis and appropriate treatment, the vast majority of patients are either freed from their symptoms or experience significant improvement. Minimally invasive surgery is possible through modern laparoscopic techniques.
Frequently Asked Questions
What causes pelvic organ prolapse?
Pelvic organ prolapse most commonly develops due to birth trauma, advanced age, and hormonal changes after menopause. The main risk factors include multiple vaginal deliveries, the birth of a large baby, chronic constipation, heavy lifting, obesity, and genetic predisposition. As the muscles and connective tissue supporting the pelvic floor weaken, the pelvic organs descend from their normal position.
Can pelvic organ prolapse be treated without surgery?
Yes, in mild to moderate-stage prolapse, non-surgical methods are highly successful. Within the scope of pelvic organ prolapse treatment, the majority of patients achieve significant relief through regular Kegel exercises, pessary use, local estrogen therapy, and lifestyle modifications.
What is laparoscopic sacrocolpopexy?
Laparoscopic sacrocolpopexy is the laparoscopic surgical method considered the gold standard for advanced-stage pelvic organ prolapse. It is based on attaching the vagina to the sacrum using a special synthetic mesh. The procedure offers a success rate of over 95%, along with the advantages of small incision scars, rapid recovery, and minimal pain.
When can I return to normal life after pelvic organ prolapse surgery?
After laparoscopic surgery, patients are typically discharged within 2-3 days. Light activities can be resumed within 1-2 weeks, while a return to normal life is possible 4-6 weeks after surgery. A return to sexual life is recommended after 6 weeks, and heavy lifting and strenuous exercise after 3 months. The recovery process may vary depending on the patient and the technique applied.
Is there a risk of recurrence after pelvic organ prolapse surgery?
With modern laparoscopic techniques, the risk of recurrence is quite low (5-10%). To prevent recurrence, weight control, regular Kegel exercises, avoidance of heavy lifting, and the treatment of chronic coughing or constipation are important. Following the follow-up program recommended by your physician is critical for long-term success.
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References
The medical content on this page has been prepared based on the current clinical guidelines and scientific publications of international and national authoritative organizations. A valuable feature of this page is the inclusion of an academic article by Assoc. Prof. Dr. Pınar Kadiroğulları on pelvic organ prolapse surgery as a direct reference.
ACOG/AUGS Joint Practice Bulletin No. 214: Diagnosis and Management of Pelvic Organ Prolapse
Authors: American College of Obstetricians and Gynecologists (ACOG) & American Urogynecologic Society (AUGS) | Publication: Obstet Gynecol 2019;134:e126-e142 | Source Type: International Joint Clinical Practice Guideline (PubMed)
NICE NG123: Urinary Incontinence and Pelvic Organ Prolapse in Women — UK National Clinical Guideline
Author: National Institute for Health and Care Excellence (NICE) | Publication: NICE Guideline NG123 | Source Type: National Clinical Guideline
IUGA/ICS Joint Report: Terminology of Pelvic Floor Disorders & the POP-Q Staging System
Authors: International Urogynecological Association (IUGA) & International Continence Society (ICS) | Publication: International Urogynecology Journal 2022 | Source Type: International Consensus Report
POP Treatment with Vaginal Hysterectomy and Uterosacral Ligament Suspension (USLS): A Turkish Study of 53 Cases
Author Institutions: Bakırköy Dr. Sadi Konuk Training and Research Hospital & Istanbul Aydın University | Publication: Revista da Associação Médica Brasileira 2024 | Study: 53 patients with severe prolapse, mean age 61.7 | Source Type: Turkish Peer-Reviewed Clinical Study (PubMed PMC, Full Text)
Uterosacral Ligament Suspension via the vNOTES Technique: A Pilot Study of 35 Cases in Severe Pelvic Organ Prolapse
Study: POP-Q and PISQ-12 sexual function scores | Publication: BMC Surgery 2021 | Source Type: Peer-Reviewed Clinical Study (PubMed PMC, Full Text)
Open Abdominal vs Laparoscopic Bilateral Uterosacral Ligament Replacement: A Comparison of 145 Cases
Study: 75 CESA + 70 laCESA, 1-year follow-up | Publication: Peer-Reviewed Clinical Study 2025 | Source Type: Comparative Clinical Study (PubMed PMC, Full Text)
Evaluation and Management of Pelvic Organ Prolapse: A Comprehensive Mayo Clinic Clinical Review
Publication: Mayo Clinic Proceedings 2021 | Source Type: Peer-Reviewed Clinical Review — Pessary, Pelvic Floor Exercise, and Surgical Approaches
⭐ Academic Publications by Assoc. Prof. Dr. Pınar Kadiroğulları on Pelvic Organ Prolapse Surgery
Directly related to pelvic organ prolapse (POP) — scientific publications authored by the doctor in the fields of uterosacral ligament suspension and vaginal surgery
Modified Extraperitoneal Uterosacral Ligament Suspension: Prevention of Apical Prolapse After Vaginal Hysterectomy — A 4-Clamp Technique
Authors: Kadiroğulları P, Seçkin KD | Publication: Journal of Investigative Surgery 2019 | Source Type: Peer-Reviewed Pelvic Surgery Clinical Research (PubMed)
📍 This publication is directly focused on the surgical treatment of pelvic organ prolapse — it describes the modified uterosacral ligament suspension technique that provides apical compartment support. It serves as a direct clinical reference in the surgical treatment of pelvic organ prolapse.
Abdominal Hysterectomy with a Uterine Manipulator: Preservation of Vaginal Length and Anatomical Integrity
Authors: Kıyak H, Karacan T, Özyürek ES, Türkgeldi LS, Kadiroğulları P, Seçkin KD | Publication: Journal of Investigative Surgery 2021;34(10):1052-1058 | Source Type: Randomized Controlled Clinical Trial (PubMed)
Clitoral Hoodoplasty and Sexual Function: Its Effect on Quality of Life After Pelvic Surgery
Authors: Bozkurt Köseoğlu S, Çalışkan E, Kadiroğulları P | Publication: Anatolian Journal of Obstetrics and Gynecology Research 2024 | Source Type: Turkish Peer-Reviewed Review
Important Note
The information on this page is intended for general informational purposes and does not replace individual medical advice. For personal questions regarding the diagnosis of pelvic organ prolapse, treatment planning, and your health, you should always consult your specialist gynecologist. The content of this page has been prepared by Assoc. Prof. Dr. Pınar Kadiroğulları in light of clinical experience and current scientific literature.
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