Pelvic organ prolapse surgery recovery time: the short version
ACOG says recovery varies with the type of surgery, that you usually need to take a few weeks off work, and that for the first few weeks you should avoid vigorous exercise, lifting and straining, and avoid sex for several weeks. Surgery through the vagina usually means a shorter recovery than surgery through the abdomen. IUGA gives a similar picture for vaginal repair: most people return to work between 2 and 6 weeks, and lifting more than 20 pounds (9 kg) and high-impact exercise wait at least 6 weeks.
Podo's own timings are below. Plan for 5 to 10 days in Seoul after incontinence or prolapse surgery. A final check is done 5 to 10 days after surgery, before you fly home. The milestones that follow show how the weeks fit together.
Before
Examination and staging, imaging where used, blood and urine tests, medication review, and a frank discussion of options including doing nothing, a pessary, or surgery.
Tests and measurement
The clinic uses vaginal endoscopy imaging to examine the vaginal wall before treatment. Vaginal laxity is measured numerically rather than judged by hand. A pre-operative safety check-up is completed before every surgery.
Pessaries are not fitted or managed at the clinic, and a pessary trial is not required before surgery. NICE recommends patient decision aids on uterine prolapse and vaginal vault prolapse where they apply, so that you can weigh the options before you decide.
POP surgery: what to expect on the day
Anesthesia planned for you; most vaginal repairs take one to two hours. A catheter may be used overnight; at Podo it is usually removed the morning after surgery.
Anesthesia and the operating room
Anesthesia follows a four-step protocol tailored to the procedure and the patient. Surgery is performed in the clinic's own operating room.
Your team will tell you when to stop eating and drinking. Follow those times exactly, because food in the stomach adds risk during sedation and anesthesia.
The stay
One night in hospital is typical for vaginal repairs; longer for abdominal approaches. At Podo, plan for 5 to 10 days in Seoul. The final check is done 5 to 10 days after surgery, before you fly home.
Patients have a 24-hour nurse contact line after surgery. A video follow-up is scheduled after you return home.
Recovery milestones
Walking from day one. At Podo, you can usually drive after about 1 week and return to work after about 1 month. Swimming and running wait about 2 months. Do not lift more than 10 kilograms (about 22 pounds) for 8 weeks.
Intercourse waits about 8 weeks after pelvic ligament suspension, once a check confirms healing. Final healing takes about three months.
IUGA adds that pelvic floor exercises are usually safe to start about 1 to 2 weeks after surgery, but you should confirm with your doctor, and that you should not try to build fitness for at least 6 weeks. The evidence behind activity limits is thin: a 2013 review found no randomized trial or prospective cohort study testing how long restrictions are needed after gynecologic surgery. Follow the limits your own surgeon gives you.
Bowel and bladder function
Constipation is common after prolapse surgery, and straining puts pressure on the stitches. The International Urogynecological Association (IUGA) advises plenty of fruit and fiber, enough fluid to keep stools soft, and a stool softener if your doctor prescribes one.
About 15% of women have trouble emptying the bladder fully, according to IUGA, and this usually settles within a few days to 2 weeks. Pain around the vagina and groin eases over several weeks. Medicine may reduce it without removing it completely.
When to call
Contact your surgeon promptly for heavy bleeding, foul-smelling or prolonged discharge, burning when you pass urine, increasing abdominal pain, vomiting or fever.
IUGA also lists a painful swollen leg, shortness of breath and chest pain as reasons to seek urgent help.
Pelvic organ prolapse surgery success rate: how it is measured
By symptoms as much as by anatomy: no bulge you can feel, normal bladder and bowel emptying, comfort. Recurrence is possible after any repair and depends on tissue and activity.
There is no single success rate, because studies define success differently. In the OPTIMAL trial, published in JAMA in 2014, 374 US women having surgery for apical prolapse and stress incontinence were randomly assigned to one of two vaginal native-tissue operations. Success meant no bothersome bulge, no descent beyond set limits on examination and no retreatment. At 2 years about 6 in 10 women met that standard (59% and 61%).
ACOG lists being younger than 60, being overweight and having more advanced prolapse before the first operation as risk factors for the prolapse returning, and says it is not known whether anything can prevent it. NICE asks surgeons to discuss the risk that prolapse returns and how little is known about long-term adverse effects, particularly for procedures that use mesh. A good consultation covers both before you agree to surgery.
At Podo
Pelvic ligament suspension is the technique used; each condition has its own page with the day-by-day plan.
Pelvic ligament suspension uses the patient's own ligaments and sutures, without synthetic mesh. Results and recovery vary from person to person.
Questions
How long will I stay in Seoul after prolapse surgery?
Plan for 5 to 10 days in Seoul after incontinence or prolapse surgery. A final check is done 5 to 10 days after surgery, before you fly home.
When is the catheter taken out?
The urinary catheter is usually removed the morning after surgery. If emptying your bladder feels slow afterward, tell the nurse.
Do I have to try a pessary first?
No. Pessaries are not fitted or managed at the clinic, and a pessary trial is not required before surgery.
Who do I call with a question after I leave?
Patients have a 24-hour nurse contact line after surgery. A video follow-up is scheduled after you return home.
How long is pelvic organ prolapse surgery recovery?
It varies with the operation. ACOG says you usually need a few weeks off work and should avoid vigorous exercise, lifting and straining for the first few weeks. Plan for 5 to 10 days in Seoul after incontinence or prolapse surgery. Results and recovery vary from person to person.
What is the newest surgery for prolapsed bladder?
No single newest operation replaces the established ones. Newer ligament-based native-tissue techniques exist, such as the pelvic ligament suspension used at Podo, but they have fewer years of published follow-up than slings and standard repairs. In the US, mesh placed through the vagina to repair prolapse stopped being sold after an FDA order in April 2019, and NICE advises offering anterior repair without mesh. Bladder lift surgery is a lay term that covers several different operations, so ask your surgeon which one is proposed.
Sources
- NICE guideline NG123: Urinary incontinence and pelvic organ prolapse in women: management
- IUGA Your Pelvic Floor: Recovery guide after pelvic floor surgery
- ACOG FAQ: Surgery for Pelvic Organ Prolapse
- OPTIMAL randomized trial (Barber et al., JAMA 2014): two transvaginal operations for apical prolapse, PMC4083455
- FDA: Urogynecologic surgical mesh, FDA's activities
- Nygaard IE et al. Activity restrictions after gynecologic surgery: is there evidence? Int Urogynecol J 2013 (PMC3774134)
Read about this at Podo
About the reviewer
Dr. Mo Hyung-jin, MD, PhD, board-certified OB-GYN specialist, is the medical director of Podo Women's Clinic. He developed the pelvic ligament suspension technique used at the clinic for stress urinary incontinence and pelvic organ prolapse. Profile