Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed March 2026
Can Prolapse Come Back After Surgery?
Yes, prolapse can recur after surgery, but it’s important to understand what recurrence actually means. The word sounds alarming, but many women who have anatomic recurrence on exam never develop bothersome symptoms. Understanding the difference between what your surgeon sees and what you feel helps put this concern in perspective.
Understanding Recurrence Rates
There’s an important distinction:
- Anatomic recurrence (visible on exam): ~30-40% over many years, depending on the procedure performed
- Symptomatic recurrence (bothersome enough to need treatment): ~10-15%
When I discuss recurrence with patients, I always clarify this distinction. Many women have some mild descent on exam years later but feel perfectly fine. If it’s not bothering you, it doesn’t need treatment.
Risk Factors for Recurrence
Some factors increase the likelihood of prolapse returning:
- Chronic straining — constipation, heavy lifting, chronic cough
- Obesity — increased abdominal pressure on the repair
- Connective tissue quality — some women have inherently weaker support
- Severity of original prolapse — more advanced prolapse has higher recurrence
- Age at surgery — younger women have more years for wear and tear
Reducing Your Risk
You can meaningfully reduce recurrence risk by:
- Managing constipation — avoid straining with bowel movements
- Maintaining healthy weight — reduces pressure on the repair
- Pelvic floor exercises — strengthens the muscles supporting the repair
- Avoiding chronic heavy lifting — especially in the first year
- Treating chronic cough — including smoking cessation
If Prolapse Does Recur
Recurrence doesn’t necessarily mean another surgery. Options include:
- Observation if symptoms are mild
- Pessary for non-surgical management
- Pelvic floor physical therapy
- Repeat surgery if symptoms are significantly bothersome
I always discuss recurrence honestly before surgery. But I also reassure patients that the majority do well long-term, and even if there’s some recurrence, it’s usually manageable. The goal is significant improvement — and most women achieve that.
References
- Barber MD, Brubaker L, Nygaard I, et al. Defining success after surgery for pelvic organ prolapse. Obstet Gynecol. 2009;114(3):600-609. PMID: 19701038
- Nygaard I, Brubaker L, Zyczynski HM, et al. Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse. JAMA. 2013;309(19):2016-2024. PMID: 23677313
- Barber MD, Brubaker L, Burgio KL, et al. Comparison of 2 transvaginal surgical approaches and perioperative behavioral therapy for apical vaginal prolapse: the OPTIMAL randomized trial. JAMA. 2014;311(10):1023-1034. PMID: 24618964
- Jelovsek JE, Barber MD, Brubaker L, et al. Effect of uterosacral ligament suspension vs sacrospinous ligament fixation with or without perioperative behavioral therapy for pelvic organ prolapse on surgical outcomes and prolapse symptoms at 5 years in the OPTIMAL randomized clinical trial. JAMA. 2018;319(15):1554-1565. PMID: 29677302
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