Fellowship-Trained Urogynecologist
Urogynecology & Reconstructive Pelvic Surgery
Green Bay, Wisconsin
✓ Medically reviewed May 15, 2026
Can prolapse come back after surgery?
Yes, prolapse can come back after surgery. But before you worry, it helps to understand what “recurrence” actually means. The word sounds scary. In practice, many women who show some change on exam never feel any bothersome symptoms at all.
What the numbers really mean
There is an important difference between what your surgeon sees on exam and what you feel day to day.
- Anatomic recurrence (visible on exam): about 30-40% over several years, depending on the procedure
- Symptomatic recurrence (bothersome enough to need treatment): about 10-15%
When I talk with patients about this, I focus on that gap. In the PFDR-R multicenter registry, retreatment rates were under 2% at each time point through 36 months, and over 93% of patients reported feeling much better.
Research also shows that recurrence is not a one-way street. In long-term studies, about one-third of women who met “failure” criteria at one visit later met success criteria at a later visit without any additional treatment. So a finding on one exam does not always mean things are getting worse.
Risk factors for recurrence
Some things raise the chance of prolapse returning after surgery:
- Chronic straining from constipation, heavy lifting, or chronic cough
- Higher body weight, which puts more pressure on the repair (about 1.7 times the risk for each 5 kg/m2 increase in BMI)
- More advanced prolapse at the time of surgery
- Prior hysterectomy (associated with about 1.8 times the risk in registry data)
- Connective tissue quality, which varies from person to person
- Smoking, which impairs tissue healing
We’ll talk through which of these apply to you so we can plan together.
Reducing your risk
You can take steps that help protect your repair:
- Manage constipation so you are not straining with bowel movements
- Stay at a healthy weight to reduce pressure on the repair
- Work with a pelvic floor physical therapist. This is more than just Kegels. A PT works on muscle strength, coordination, relaxation, endurance, breathing, and the surrounding muscles of your hips, core, and thighs. We have pelvic floor PTs in our office who can work with you before and after surgery.
- Avoid repeated heavy lifting, especially in the first year after surgery
- Treat a chronic cough. If you smoke, quitting helps your tissues heal and stay strong.
If prolapse does come back
Recurrence does not automatically mean another surgery. We will talk through the options together based on what is bothering you:
- Watching and waiting if symptoms are mild
- A pessary (a removable device that supports the vaginal walls)
- Pelvic floor physical therapy
- Repeat surgery if symptoms are really getting in the way of your daily life
I bring up recurrence honestly before surgery so you know what to expect. Most women do well long-term. Even when there is some recurrence, it is usually manageable. The goal is not perfection on an exam. The goal is for you to feel better in your daily life.
References
- Barber MD, Brubaker L, Nygaard I, et al. Defining success after surgery for pelvic organ prolapse. Obstet Gynecol. 2009;114(3):600-609. doi:10.1097/AOG.0b013e3181b2b1ae
- Nygaard I, Brubaker L, Zyczynski HM, et al. Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse. JAMA. 2013;309(19):2016-2024. doi:10.1001/jama.2013.4919
- 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. doi:10.1001/jama.2014.1719
- 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. doi:10.1001/jama.2018.2827
- Ferrando CA, Bradley CS, Meyn LA, et al. Twelve month outcomes of pelvic organ prolapse surgery in patients enrolled in the multicenter Pelvic Floor Disorders Registry. Urogynecology. 2023. doi:10.1097/SPV.0000000000001410
- Andy UU, Meyn L, Brown HW, et al. Outcomes at 12, 24, and 36 months in women treated for pelvic organ prolapse with pessary or surgery: results from the multicenter Pelvic Floor Disorders Registry. Urogynecology. 2025. doi:10.1097/SPV.0000000000001669
- Carberry CL, Tulikangas PK, Ridgeway BM, et al. American Urogynecologic Society best practice statement: evaluation and counseling of patients with pelvic organ prolapse. Urogynecology. 2025. doi:10.1097/SPV.0000000000001641
- Chang OH, Carter Ramirez A, Edwards A, et al. The role of uterine preservation at the time of pelvic organ prolapse surgery. Urogynecology. 2025. doi:10.1097/SPV.0000000000001667
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