This protocol addresses cystocele presenting as recurrent vaginal apex prolapse in patients who have already undergone — and failed — a vaginal native tissue apical suspension. Recurrence after pelvic organ prolapse surgery is a recognised clinical reality, and a structured approach is needed when the initial repair has not held.
Recurrence of pelvic organ prolapse (POP) is possible after any POP surgery. This scenario applies specifically to patients with recurrent vaginal apex prolapse who have a history of prior failed vaginal native tissue apical suspension and are now being evaluated for further surgical management.
When surgery is chosen for recurrent apex prolapse in this setting, the approach typically shifts away from a repeat native tissue vaginal repair. Abdominal-route or augmented procedures form part of the options considered — the complete algorithm, criteria, and decision framework are in the full protocol.
DOI: 10.1097/AOG.0000000000003519
Recurrence of POP is possible after any POP surgery.
If a patient chooses to undergo surgery for recurrent vaginal apex prolapse, abdominal sacrocolpopexy, vaginal colpopexy with possible mesh or graft augmentation, or colpocleisis may be considered if the patient has failed a vaginal native tissue apical suspension.
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