Pelvic Organ Prolapse Surgery: Types, Recovery & Non-Surgical Alternatives

While not always the case, it’s not uncommon for women to experience pelvic organ prolapse after pregnancy and childbirth. This occurs when one of your pelvic organs ‘drops’ because it is no longer held in the correct position.

Although this can be rather distressing to experience, there are a variety of prolapse surgery and non-surgical solutions out there that have proven to be successful in minimising and reversing the effects of pelvic prolapses.

Why might you need pelvic floor surgery?

Whether you experienced a difficult pregnancy or a long birth, there’s no way to tell which, if any of your pelvic organs, has the potential to prolapse. However, common prolapsed organs usually include:

• bladder prolapse (cystocele) also known as a front wall prolapse
• Urethral prolapse also known as a front wall prolapse
• uterine (womb) prolapse - apical prolapse
• Vaginal vault prolapse - apical prolapse
• bowel prolapse (enterocele) also known as a back wall prolapse
• rectal prolapse (rectocele) also known as a back wall prolapse

Regardless, any prolapsed organ may require surgery to return it to its normal position and give it the support it needs to steady itself. But, with that being said, it’s up to your surgeon to decide if an operation is required.

And, naturally, if your surgeon does decide that surgery is the best option, then we want to make sure that you know all about the prolapse repair process, as well as life after prolapse surgery so that you can have a swift recovery.

What Are the Different Types of Prolapse Surgery?

There are several different types of pelvic organ prolapse surgery, and the most suitable procedure will depend on the type and severity of prolapse, your symptoms, age, overall health, and whether you wish to preserve your uterus.

Vaginal Repair Surgery

Many prolapse procedures are performed vaginally, meaning the surgery is carried out through the vagina without external abdominal scars. Vaginal repair surgery strengthens and repairs the weakened tissues supporting the pelvic organs.

In some cases, a vaginal hysterectomy may also be recommended if the uterus has prolapsed significantly. During this procedure, the uterus is removed through the vagina, and the surrounding pelvic tissues are repaired to improve support.

Sacrospinous Fixation

Sacrospinous fixation is commonly used to support the top of the vagina, particularly after a hysterectomy or vaginal vault prolapse. During the procedure, stitches are attached to a strong ligament within the pelvis called the sacrospinous ligament to help restore vaginal support and reduce the risk of recurrent prolapse.

Sacrocolpopexy

Sacrocolpopexy is often recommended for more severe or recurrent prolapse cases. This procedure is usually performed through the abdomen, either via open surgery, keyhole surgery (laparoscopy), or robotic-assisted surgery.

During the operation, the vagina is supported and attached to strong ligaments near the sacrum (the lower part of the spine) using a surgical mesh to provide long-term support and restore pelvic anatomy.

Surgery for Stress Urinary Incontinence

Some women with pelvic organ prolapse also experience stress urinary incontinence, where bladder leaks occur during coughing, sneezing, laughing, or exercise. In these cases, additional continence procedures — such as a mid-urethral sling (TVT or TOT) — may sometimes be performed alongside prolapse surgery to help support the urethra and improve bladder control.

Combined Pelvic Floor Surgery

If more than one pelvic organ is affected — such as the bladder, uterus, bowel, or vaginal walls — a more complex or combined surgical approach may be needed to restore pelvic support and improve symptoms.

Your healthcare professional will discuss the most appropriate treatment options based on your individual symptoms, lifestyle, and long-term pelvic health goals.

What Are the Risks of Prolapse Surgery?

As with any surgery, pelvic organ prolapse surgery carries potential risks and recovery considerations. While many women experience significant improvement in prolapse symptoms after surgery, it’s important to understand that surgery alone does not address the underlying pelvic floor weakness that contributed to the prolapse in the first place.

Possible Risks and Considerations

Mesh Complications

In some prolapse procedures, surgical mesh may be used to provide additional pelvic support. Although uncommon, complications such as mesh erosion, irritation, pain, or infection can occur and may require additional treatment or surgery.

Prolapse Recurrence

Research shows that some women may experience another prolapse in the future, even after successful surgery. This is often because the pelvic floor muscles and connective tissues remain weakened over time due to factors such as childbirth, menopause, chronic constipation, heavy lifting, or ageing.

This is why pelvic floor rehabilitation before and after surgery is so important. Strengthening the pelvic floor muscles can help improve support, optimise surgical outcomes, and reduce the risk of future prolapse symptoms. Kegel8 has a 12 week rehabilitation programme for women following surgery devised by Top Physio Amanda Savage.

Persistent Bladder or Bowel Symptoms

While prolapse surgery may relieve the feeling of heaviness, bulging, or dragging, some women may continue to experience symptoms such as bladder leaks, urgency, constipation, or pelvic floor weakness. This is because prolapse surgery repairs anatomy, but pelvic floor muscle function often still requires rehabilitation and ongoing support.

Non-Surgical Prolapse Management Options

Surgery is not always the first or only treatment option for pelvic organ prolapse. Many women successfully manage their symptoms conservatively, either long term or while waiting for surgery.

Pelvic Floor Exercises and Kegel8 Support

Pelvic floor muscle training is one of the most important treatments for prolapse management at every stage — before surgery, while waiting for surgery, and during post-surgical recovery.

Manual Kegel exercises can help strengthen and support the pelvic floor muscles, but many women benefit from additional support using a pelvic floor toner such as the Kegel8 Ultra 20. Kegel8 uses gentle neuromuscular electrical stimulation (NMES) to help improve pelvic floor muscle activation, strength, circulation, and awareness.

Using pelvic floor rehabilitation before surgery may help improve pelvic support and symptom management while preparing the muscles for recovery afterwards. Following surgery, ongoing pelvic floor rehabilitation is equally important to help restore muscle function and maintain long-term pelvic support.

Kegel8 also offers a dedicated 12-week post-surgery pelvic floor rehabilitation plan written by Specialist Pelvic Health Physiotherapist Amanda Savage, designed to help women safely rebuild pelvic floor strength and confidence during recovery.

Please note: electronic pelvic floor stimulation should only be restarted once your surgeon or healthcare professional confirms it is safe to do so following surgery.

Vaginal Pessaries

Vaginal pessaries are a common non-surgical treatment for pelvic organ prolapse and stress urinary incontinence. These removable medical devices provide internal support to help reduce prolapse symptoms such as heaviness, pressure, and bladder leaks.

For many women, pessaries provide an excellent long-term management option, while others use them temporarily while strengthening their pelvic floor, improving bowel habits, losing weight, or waiting for prolapse surgery.

Some women choose clinician-fitted prolapse pessaries, while others successfully self-manage certain pessary types at home for flexibility, comfort, and symptom control during exercise or long days on their feet.

Lifestyle and Pelvic Health Support

Conservative prolapse management may also include:

• Improving constipation and bowel habits use a toilet stool.
• Reducing heavy straining
• Regular pelvic floor exercise to keep the support and strength in the pelvic floor muscles.
• Maintaining a healthy weight see our Top Tips on Weight loss for a Healthier Pelvic Floor.
• Using pelvic support garments
• Managing menopause symptoms with appropriate medical support
• Avoiding repetitive heavy lifting where possible

Early pelvic floor support and symptom management can make a significant difference to long-term pelvic health and quality of life. If you experience symptoms of prolapse, it’s important to seek professional advice early so you can explore the most suitable treatment and support options for your needs.