The risk of pelvic organ prolapse (POP) recurrence after surgical reconstruction is not uncommon. Up to 30% of women undergoing one POP procedure have at least one more procedure, although recent studies suggest a lower recurrence rate (near 10% of patients requiring reoperation).[21]Olsen AL, Smith VJ, Bergstrom JO, et al. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997 Apr;89(4):501-6.
http://www.ncbi.nlm.nih.gov/pubmed/9083302?tool=bestpractice.com
[66]Dällenbach P. To mesh or not to mesh: a review of pelvic organ reconstructive surgery. Int J Womens Health. 2015;7:331-43.
https://www.dovepress.com/to-mesh-or-not-to-mesh-a-review-of-pelvic-organnbspreconstructive-surg-peer-reviewed-fulltext-article-IJWH
http://www.ncbi.nlm.nih.gov/pubmed/25848324?tool=bestpractice.com
Women with a more severe prolapse are more likely to have a recurrence.[67]Whiteside JL, Weber AM, Meyn LA, et al. Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol. 2004 Nov;191(5):1533-8.
http://www.ncbi.nlm.nih.gov/pubmed/15547521?tool=bestpractice.com
[68]Lavelle ES, Giugale LE, Winger DG, et al. Prolapse recurrence following sacrocolpopexy vs uterosacral ligament suspension: a comparison stratified by Pelvic Organ Prolapse Quantification stage. Am J Obstet Gynecol. 2018 Jan;218(1):116.e1-e5.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8513726
http://www.ncbi.nlm.nih.gov/pubmed/28951262?tool=bestpractice.com
Among patients with stage 2 POP, recurrence rates following uterosacral ligament suspension and sacrocolpopexy are comparable.[68]Lavelle ES, Giugale LE, Winger DG, et al. Prolapse recurrence following sacrocolpopexy vs uterosacral ligament suspension: a comparison stratified by Pelvic Organ Prolapse Quantification stage. Am J Obstet Gynecol. 2018 Jan;218(1):116.e1-e5.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8513726
http://www.ncbi.nlm.nih.gov/pubmed/28951262?tool=bestpractice.com
Among women with higher stage apical prolapses, abdominal sacrocolpopexy is the most durable surgical repair procedure; the anatomical success rate ranges from 76% to 100%.[22]American College of Obstetricians and Gynecologists. Practice bulletin no. 214: pelvic organ prolapse. Nov 2019 [internet publication].
https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2019/11/pelvic-organ-prolapse
[55]Maher C, Feiner B, Baessler K, et al. Surgery for women with anterior compartment prolapse. Cochrane Database Syst Rev. 2016 Nov 30;(11):CD004014.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004014.pub6/full
http://www.ncbi.nlm.nih.gov/pubmed/27901278?tool=bestpractice.com
[57]Nygaard IE, McCreery R, Brubaker L, et al. Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol. 2004 Oct;104(4):805-23.
http://www.ncbi.nlm.nih.gov/pubmed/15458906?tool=bestpractice.com
[68]Lavelle ES, Giugale LE, Winger DG, et al. Prolapse recurrence following sacrocolpopexy vs uterosacral ligament suspension: a comparison stratified by Pelvic Organ Prolapse Quantification stage. Am J Obstet Gynecol. 2018 Jan;218(1):116.e1-e5.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8513726
http://www.ncbi.nlm.nih.gov/pubmed/28951262?tool=bestpractice.com
[69]Culligan PJ, Murphy M, Blackwell L, et al. Long-term success of abdominal sacral colpopexy using synthetic mesh. Am J Obstet Gynecol. 2002 Dec;187(6):1473-80.
http://www.ncbi.nlm.nih.gov/pubmed/12501049?tool=bestpractice.com
[70]Imparato E, Aspesi G, Rovetta E, et al. Surgical management and prevention of vaginal vault prolapse. Surg Gynecol Obstet. 1992 Sep;175(3):233-7.
http://www.ncbi.nlm.nih.gov/pubmed/1514157?tool=bestpractice.com
[71]Bensinger G, Lind L, Lesser M, et al. Abdominal sacral suspensions: analysis of complications using permanent mesh. Am J Obstet Gynecol. 2005 Dec;193(6):2094-8.
http://www.ncbi.nlm.nih.gov/pubmed/16325622?tool=bestpractice.com
[72]Maher CF, Qatawneh AM, Dwyer PL, et al. Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: a prospective randomized study. Am J Obstet Gynecol. 2004 Jan;190(1):20-6.
http://www.ncbi.nlm.nih.gov/pubmed/14749629?tool=bestpractice.com
Vaginal procedures may have a relatively lower success rate. The 5-year success rates of vaginal uterosacral procedures range from 87% to 89%.[73]Barber MD, Visco AG, Weidner AC, et al. Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse. Am J Obstet Gynecol. 2000 Dec;183(6):1402-10.
http://www.ncbi.nlm.nih.gov/pubmed/11120503?tool=bestpractice.com
[74]Karram M, Goldwasser S, Kleeman S, et al. High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse. Am J Obstet Gynecol. 2001 Dec;185(6):1339-42.
http://www.ncbi.nlm.nih.gov/pubmed/11744906?tool=bestpractice.com
There is no evidence that any specific post-surgical activity restrictions reduce the risk of recurrence. Nonetheless, some physicians restrict patients from heavy lifting (4.5 kg or 10 lb), and from vaginal intercourse for 6 weeks following surgery.