Evaluation and Management of Recurrent Pelvic Organ Prolapse

Postoperative prolapse recurrence is not uncommon, despite advances in surgical options and techniques. There is no consensus on the optimal approach to guide counseling and management for patients with recurrent prolapse following surgical repair.

Risk factors for postoperative prolapse recurrence include patient factors, pelvic floor factors, and surgical approach. There are various definitions for prolapse recurrence, including anatomic measures and patient reported symptoms. The highest rate of prolapse recurrence is seen within two years of initial surgery. Retreatment for prolapse requires shared decision-making, considering the patient's symptomatology, anatomy, comorbidities, and long-term goals. There is limited data regarding the long-term success of reoperation for pelvic organ prolapse. Anatomic and patient factors that affect surgical re-treatment outcomes for recurrent prolapse are not well understood. Standardized definitions of prolapse recurrence and more long-term data are necessary to inform evidence-based treatment decisions.