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
[68]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.[69]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
[70]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.[70]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 anatomic 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
[70]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
[71]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
[72]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
[73]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
[74]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%.[75]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
[76]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 postsurgical activity restrictions reduce the risk of recurrence. Nonetheless, some physicians restrict patients from heavy lifting (10 lb), and from vaginal intercourse for 6 weeks following surgery.