Treatment › Will it come back?
Will it come back?
"I know it is not a permanent fix. Has anyone had it come back?" If you have asked that, either before surgery or lying awake afterwards, you deserve a straight answer rather than reassurance or doom. Here it is.
The honest numbers
Some studies report that 30 to 40 percent of women show some degree of anatomical prolapse on examination in the years after a repair. Anterior, or bladder, repairs recur more often than posterior ones for rectocele, which succeed roughly 80 to 90 percent of the time. On their own those figures sound alarming. They also hide the number that actually matters.
An anatomical finding is not the same as a problem. In one careful study, about half of women showed some anatomical recurrence on examination two years after cystocele repair, yet fewer than one in ten actually felt symptoms again. In a large national registry following thousands of women, only 11 percent had repeat surgery within five years, rising to about 15 percent by ten years.
Put plainly: most women who have prolapse surgery never need another operation.
Why recurrence happens
- The tissue factors that allowed prolapse the first time, such as connective tissue quality and muscle injury from childbirth, are still there after the repair.
- More advanced prolapse before surgery, and significant pelvic muscle injury, are the strongest predictors.
- Sometimes what gets called a recurrence is really a different compartment prolapsing for the first time. That is a new issue, not a failed repair.
What you can do to protect your repair
- Keep constipation managed for life, not just during recovery.
- Consider pelvic floor physiotherapy once you have healed, to strengthen the muscle support around the repair.
- Ask your surgeon whether local vaginal estrogen makes sense for your tissue health.
- Go to your follow ups even when you feel fine, and report new symptoms early. Small issues are far easier to address than advanced ones.
If it does come back
It is not a dead end, and it is not your fault. Options remain. Pessaries work after surgery too, repeat repairs are common and often successful, and for some women colpocleisis becomes the definitive fix. Women in our community have walked every one of these paths, so ask them anything.