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Pelvic organ prolapse surgery in Korea

Pelvic organ prolapse is when the bladder, rectum or uterus drops from its normal position and presses into the vagina. It is described by what has dropped: cystocele (bladder), rectocele (rectum), uterine prolapse (uterus), and often more than one at once. Gangnam Podo Women's Clinic in Seoul, Korea, repairs prolapse with pelvic ligament suspension surgery, a technique developed by our medical director that re-anchors the supports rather than only tightening the wall.

Medically reviewed by Dr. Mo Hyung-jin, MD, PhD, board-certified OB-GYN specialist · Last reviewed

Consultations in English · Private single-occupancy recovery suites · Insurance claim documents prepared

Dr. Mo Hyung-jin showing a patient the pelvic floor on an anatomical model
Explaining the pelvic supports on a model

How Podo approaches prolapse

Two of the clinic's three OB-GYN specialists are women. This page is general information and is not a diagnosis; a consultation is needed to decide whether a procedure suits you. Consultations are available in English. Recovery rooms are private single-occupancy suites. We prepare the documents international insurers typically require: an itemized English receipt, a medical certificate, procedure codes and a completed claim form.

Prolapse is a failure of support, so we start by finding which level of support has failed: examination, vaginal endoscopy imaging and ultrasound. The repair is then directed at the ligaments involved, and where the uterus is prolapsed we discuss whether it can be preserved.

Two of our three OB-GYN specialists are women. Patients stay overnight in a private suite and leave with English discharge instructions and insurance documents.

The three levels of vaginal support (schematic) Uterus Vagina Bladder Rectum Level I — the uterosacral and cardinal ligaments suspend the cervix and upper vagina Level II — lateral attachments hold the vaginal walls between the bladder and the rectum Level III — the perineal body and muscles support the vaginal opening
Schematic, not to scale. Based on DeLancey’s three levels of vaginal support.

Pelvic organ prolapse stages and what they mean

Prolapse is commonly staged from 0 to 4 with the Pelvic Organ Prolapse Quantification (POP-Q) system, which measures the lowest point of the front wall, the back wall and the upper vagina against the hymen. Stage 1 sits well inside the vagina, stage 2 is at the opening, stage 3 is beyond it and stage 4 is complete eversion. The stage says how far something has dropped, not which organ or how much it bothers you.

By organ, a bladder dropping into the front wall is a cystocele, the rectum bulging into the back wall is a rectocele, and a uterus that has descended is uterine prolapse. After hysterectomy the upper vagina can drop, which is vaginal vault prolapse. Many women have more than one, and treatment follows the organ as much as the stage. Prolapse Stages 1 to 4 and What They Mean for Treatment explains the staging in full.

Vaginal prolapse repair in Korea without mesh

Mesh is the most debated part of prolapse surgery. In April 2019 the FDA ordered manufacturers to stop selling mesh intended for transvaginal repair of prolapse, after finding the data did not give reasonable assurance of safety and effectiveness. A 2024 Cochrane review of 51 trials and 7,846 women found that women were less likely to be aware of prolapse after transvaginal mesh repair, but that mesh exposure occurred in 11.8 percent and new stress incontinence was more common; the authors concluded that transvaginal mesh has limited utility in primary surgery. Mesh placed through the abdomen in sacrocolpopexy is a separate operation that is still performed.

Native tissue repair means the surgeon uses the patient's own tissue. The International Urogynecological Association (IUGA) describes vaginal repairs done with stitches, uterosacral or sacrospinous ligament suspensions for the uterus or vaginal vault, and notes that most repairs do not routinely require a graft. Pelvic ligament suspension is a ligament-based version of the same idea. The technique restores pelvic support by re-anchoring the patient's own lax pelvic ligaments. Pelvic ligament suspension uses the patient's own ligaments and sutures, without synthetic mesh.

What is the newest surgery for prolapsed bladder?

No single newest operation has replaced the others. The biggest change of the past decade is the move away from transvaginal mesh. What remains is a set of choices: vaginal repair with the patient's own tissue, ligament suspension, sacrocolpopexy with mesh placed through the abdomen for upper vaginal support, and, in limited cases, closing the vagina for women who do not plan sexual activity. IUGA gives long-term cure rates of roughly 75 percent for vaginal surgery and 90 to 95 percent for abdominal approaches, so ask any surgeon for the results of the exact operation proposed.

Pelvic ligament suspension surgery was developed by Dr. Mo Hyung-jin, the clinic's medical director. It is used for stress urinary incontinence, cystocele, rectocele and uterine prolapse. It was developed at one clinic, so it has far less published long-term data than the established repairs. That is a real difference, and it belongs in your decision.

Recovery and flying home after prolapse surgery

Plan for 5 to 10 days in Seoul after incontinence or prolapse surgery. A final check is done 5 to 10 days after surgery, before you fly home. You can usually drive after about 1 week and return to work after about 1 month. Swimming and running wait about 2 months. Sexual intercourse can resume about 8 weeks after pelvic ligament suspension, once a check confirms healing.

The flight home is long. The NHS lists a journey of more than 4 hours as a risk factor for deep vein thrombosis and advises moving around every hour or so, drinking water and wearing loose clothing. Ask at your final check when you may fly.

Pelvic organ prolapse surgery Korea: how to plan the trip

If you are researching pelvic organ prolapse surgery Korea clinics from abroad, start with what happens before and after the trip. Pessaries are not fitted or managed at the clinic, and a pessary trial is not required before surgery. If you want to try a pessary first, which the NHS and IUGA both describe as a non-surgical option, that trial would need to happen with a gynecologist or urogynecologist at home before you travel.

The CDC advises travelers to check the qualifications of the clinician and the facility and to get copies of all medical records before returning home. Bring records of any earlier pelvic surgery, with implant details. Patients who have a sling or mesh from another clinic can be treated; if the existing mesh is well positioned, it is left in place and pelvic ligament suspension is performed.

In this section

Questions

Do I need surgery, or can exercises help?

Mild prolapse often improves with pelvic floor training and a pessary can help some women. When the bulge is beyond the opening or symptoms limit daily life, surgery is usually discussed. Measurement helps decide.

Can I fly home after prolapse surgery?

Yes, once a final check confirms healing. The check is done 5 to 10 days after surgery, so plan for 5 to 10 days in Seoul.

Is mesh used in prolapse surgery at Podo?

No. Pelvic ligament suspension uses the patient's own ligaments and sutures, without synthetic mesh.

Is mesh still used in prolapse surgery?

Mesh placed through the vagina for prolapse was withdrawn from the US market after an FDA order in 2019, and the NHS no longer does it unless there is no alternative. Mesh placed through the abdomen in sacrocolpopexy is a separate operation that is still performed. Pelvic ligament suspension uses the patient's own ligaments and sutures, without synthetic mesh.

What can you not do after prolapse surgery?

Avoid lifting more than 10 kg (about 22 pounds) for 8 weeks after surgery. Swimming and running wait about 2 months. Over the long term, the NHS advises avoiding activities that strain the pelvic floor, such as heavy lifting, running and trampolining. Exercise and Lifting After Pelvic Floor Surgery has the details.

Is it safe to ignore a prolapse?

The NHS says that if prolapse causes no symptoms or does not bother you, you may not need treatment. Pelvic floor training, hormone treatment and a pessary are non-surgical options, and surgery is for severe prolapse. See a doctor if you feel a bulge or heaviness, have trouble emptying your bladder or bowel, or leak urine, because the plan depends on symptoms and not on the stage alone.

Sources

  1. NICE NG123: Urinary incontinence and pelvic organ prolapse in women: management
  2. ACOG FAQ: Surgery for Pelvic Organ Prolapse
  3. NHS: Pelvic organ prolapse
  4. FDA: Urogynecologic surgical mesh implants
  5. Cochrane review (2024): Transvaginal mesh or grafts or native tissue repair for vaginal prolapse
  6. IUGA Your Pelvic Floor: Pelvic organ prolapse
  7. Persu C et al. Pelvic Organ Prolapse Quantification System (POP-Q): a new era in pelvic prolapse staging. J Med Life 2011 (PMC)
  8. CDC Travelers' Health: Medical Tourism
  9. NHS: Deep vein thrombosis (DVT)

About the reviewer

Dr. Mo Hyung-jin, MD, PhD, board-certified OB-GYN specialist, is the medical director of Podo Women's Clinic. He developed the pelvic ligament suspension technique used at the clinic for stress urinary incontinence and pelvic organ prolapse. Profile

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Gangnam Podo Women's Clinic
2F, 428 Gangnam-daero, Gangnam-gu, Seoul, South Korea

Mon–Fri 10:00–19:00 · Sat 10:00–17:00
Closed Sundays and public holidays

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