Pelvic organ prolapse can cause vaginal pressure, a noticeable bulge, difficulty emptying the bladder, bowel problems, and discomfort during daily activities. When symptoms become persistent or significantly affect quality of life, Pelvic Organ Prolapse Surgery may be recommended to restore pelvic support and improve function.
Although prolapse surgery is generally considered safe when performed by an experienced specialist, every surgical procedure carries potential risks. Understanding these possible complications can help you make an informed decision and know what to expect before, during, and after treatment.
What Is Pelvic Organ Prolapse Surgery?
Pelvic organ prolapse surgery involves repairing weakened pelvic floor tissues and restoring organs such as the bladder, uterus, rectum, or vaginal vault to a more supportive position.
The specific procedure depends on the type and severity of prolapse, previous surgeries, overall health, and personal treatment goals. Surgical approaches may include vaginal repairs, native tissue repairs, uterine suspension procedures, sacrocolpopexy, or other reconstructive techniques.
Not everyone with pelvic organ prolapse needs surgery. Some patients may benefit from pelvic floor therapy, lifestyle changes, or a pessary device. You can learn more about conservative treatment options in our guide to exercises for prolapsed pelvic organs.
Common Risks of Prolapse Surgery
Most patients recover without serious complications, but your surgeon should explain the potential risks before treatment.
1. Bleeding
Some bleeding is expected with surgery. Significant bleeding is less common but can occur during or after a prolapse repair. In rare situations, additional treatment or a blood transfusion may be necessary.
Your surgeon will consider your medical history, medications, and the type of procedure when assessing your individual bleeding risk.
2. Infection
As with any operation, there is a risk of infection after pelvic reconstructive surgery. An infection may affect the surgical site, urinary tract, or other tissues involved in the procedure.
Symptoms such as fever, increasing pain, unusual drainage, or worsening redness should be reported to your healthcare provider promptly.
3. Bladder Problems
Because the bladder and urethra are located close to several pelvic structures, temporary urinary problems can occur after prolapse surgery.
Some patients may experience:
- Difficulty emptying the bladder
- Temporary urinary retention
- Increased urinary frequency or urgency
- Urinary leakage
- Changes in urination patterns
These symptoms may improve as swelling decreases and the pelvic tissues heal. In some cases, additional evaluation or treatment may be needed.
4. Injury to Nearby Organs
The pelvic area contains several closely positioned organs, including the bladder, ureters, bowel, uterus, and vaginal tissues. Although uncommon, surgery can potentially cause injury to one of these structures.
The risk depends partly on the surgical approach, anatomy, previous operations, scar tissue, and complexity of the prolapse.
Prolapse Recurrence After Surgery
One of the most important long-term considerations is that pelvic organ prolapse can return after surgery.
A surgical repair restores support to weakened tissues, but it cannot completely prevent future changes in the pelvic floor. Aging, chronic constipation, persistent coughing, obesity, heavy lifting, and other factors may contribute to recurrent prolapse.
Recurrence does not necessarily mean the original surgery failed. Some patients may develop prolapse in another part of the pelvic floor over time.
Our Pelvic Organ Prolapse Treatment in Riverside page provides additional information about symptoms, evaluation, and treatment options.
Risks Associated With Mesh in Prolapse Surgery
Mesh is used in some prolapse procedures, including certain forms of sacrocolpopexy. It is important to understand that not all mesh procedures are the same.
Transvaginal mesh products specifically marketed for pelvic organ prolapse were removed from the U.S. market following FDA action in 2019. Mesh used in abdominal or minimally invasive sacrocolpopexy is a different type of procedure.
Potential mesh-related complications can include mesh exposure or erosion, infection, pelvic pain, pain during intercourse, and the possible need for additional treatment.
If mesh is being considered, ask your urogynecologist what type of mesh will be used, where it will be placed, and why that approach is appropriate for you. Read more about the differences in our article on Mesh vs. Native Tissue Repair in Prolapse Surgery.
Sexual and Vaginal Changes
Some women experience changes in vaginal sensation, vaginal length, or sexual comfort following prolapse repair. Pain during intercourse, known as dyspareunia, can occur in some patients.
These effects vary depending on the type of prolapse, surgical technique, existing pelvic floor symptoms, and individual healing.
Discussing sexual health before surgery is important. Your surgeon can explain how the recommended procedure may affect vaginal anatomy and sexual function.
Blood Clots and Other General Surgical Risks
Major surgery can increase the risk of blood clots, particularly in patients with certain medical conditions or risk factors.
Other general surgical risks may include reactions to anesthesia, blood pressure changes, heart or breathing complications, and delayed healing.
Your healthcare team will evaluate your overall health and may recommend measures such as early movement after surgery or other preventive strategies to reduce these risks.
Sacrocolpopexy and Its Potential Complications
Sacrocolpopexy is one surgical option for certain types of apical or vaginal vault prolapse. It uses a supportive graft to suspend the vagina or vaginal vault to the sacrum.
Potential complications can include infection, bleeding, injury to nearby organs, urinary retention, mesh exposure, prolapse recurrence, and pain during intercourse.
Learn more about the procedure and its potential benefits and risks in our guide to Sacrocolpopexy for Pelvic Organ Prolapse.
How Can the Risks of Prolapse Surgery Be Reduced?
Although no surgery is completely risk-free, careful preparation and appropriate follow-up can help support a safer recovery.
Your healthcare provider may recommend:
- Reviewing all medications and supplements before surgery
- Controlling medical conditions before the procedure
- Following preoperative instructions carefully
- Avoiding smoking when advised
- Maintaining appropriate activity levels during recovery
- Preventing constipation and excessive straining
- Following restrictions on lifting and physical activity
- Attending scheduled postoperative appointments
Choosing the right procedure is also important. The best surgical approach depends on your anatomy, symptoms, previous procedures, health, and personal goals.
When Should You Contact Your Doctor After Surgery?
Some discomfort, fatigue, and changes in urination or bowel function can occur during recovery. However, certain symptoms require prompt medical attention.
Contact your healthcare provider if you develop:
- Fever or chills
- Heavy or increasing bleeding
- Severe or worsening pelvic pain
- Difficulty urinating
- Foul-smelling discharge
- Significant swelling or redness
- Shortness of breath or chest pain
- A new or worsening vaginal bulge
Severe chest pain, significant difficulty breathing, or other emergency symptoms require immediate medical attention.
Is Prolapse Surgery Right for You?
The decision to undergo Pelvic Organ Prolapse Surgery should be based on your symptoms, the severity and location of the prolapse, previous treatments, overall health, and personal goals.
Surgery may be appropriate when prolapse symptoms significantly interfere with daily life or when nonsurgical treatments have not provided adequate relief. However, treatment is highly individualized, and surgery is not automatically necessary simply because prolapse is present.
A urogynecology evaluation can help determine whether pelvic floor therapy, a pessary, lifestyle changes, or reconstructive surgery is the most appropriate option.
Frequently Asked Questions
What are the most common complications of prolapse surgery?
Common potential complications include bleeding, infection, temporary bladder problems, pain during healing, blood clots, injury to nearby organs, and recurrence of prolapse.
Can pelvic organ prolapse come back after surgery?
Yes. Prolapse can recur because surgery cannot completely prevent future weakening of pelvic support tissues. Maintaining pelvic floor health and following postoperative recommendations may help support long-term results.
Is prolapse surgery considered safe?
Prolapse surgery is generally considered safe, but every procedure has potential risks. Your individual risk depends on the type of surgery, overall health, anatomy, previous surgeries, and other factors.
Does prolapse surgery affect sexual function?
It can. Some women experience changes in vaginal anatomy or discomfort during intercourse after surgery, while others experience improved sexual comfort after prolapse symptoms are treated. Discuss your concerns with your surgeon before treatment.
Get Personalized Guidance for Pelvic Organ Prolapse
Understanding the risks and benefits of prolapse surgery is an important part of making a confident treatment decision. At California Urogynecology Center, Dr. Bilal Kaaki provides specialized urogynecologic care for women with pelvic floor disorders, including pelvic organ prolapse.
If you are experiencing pelvic pressure, vaginal bulging, bladder problems, bowel symptoms, or discomfort related to prolapse, a personalized evaluation can help identify the right treatment approach for your needs.
Schedule a consultation with California Urogynecology Center in Riverside, CA, and take the next step toward improved pelvic health and quality of life.