Recurrent Pelvic Organ Prolapse After Prior POP Surgery: When Vaginal Native Tissue Apical Suspension Has Failed

This protocol applies to women presenting with enterocele as part of recurrent pelvic organ prolapse following prior POP surgery, specifically in the context of a previously attempted vaginal native tissue apical suspension that has not produced a lasting result.

Clinical scenario: Recurrence of pelvic organ prolapse is a recognised outcome after any POP surgery. When a patient who has undergone vaginal native tissue apical suspension presents with recurrent prolapse, a structured reassessment of goals and management options is required before any further intervention is planned.

Management Approach

Counseling is a central initial step for women presenting with recurrent POP. Not all patients ultimately proceed to repeat surgery — non-operative approaches are part of the management conversation. The complete structured regimen outlines the full scope of options and the decision framework.

Instant Access to Structured Evidence-Based Regimens

References

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.
Women who present with recurrent POP should undergo counseling similar to that for women who present with primary POP.
Many patients may choose not to undergo a repeat surgery.
They may choose instead to monitor the prolapse or to use a pessary.

View source ↗