Vaginal prolapse repair (Surgical repair of pelvic organ prolapse)

What is vaginal prolapse repair?

Pelvic organ prolapse is when the bladder, bowel, womb or top of the vagina drops down and bulges into the vagina, often after childbirth or with age. It can cause a feeling of heaviness or a bulge, and bladder, bowel or sexual symptoms. It affects around 1 in 10 women over 50, although many have no symptoms.

Prolapse repair is an operation to support these organs and relieve symptoms. It is one option — many people are helped first by pelvic floor physiotherapy, lifestyle changes, vaginal oestrogen or a pessary (a support device). Surgery is usually considered when symptoms are troublesome and other measures have not been enough, and it is a decision to be shared between you and your surgeon.

No prolapse operation can be guaranteed to cure the prolapse for good. Around 25 to 30 in 100 women who have prolapse surgery develop a prolapse again in the future, sometimes in a different part of the vagina.

This guide explains the types of repair, what to expect, and the important history around vaginal mesh in the UK. It does not replace a personal discussion with your surgeon.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Pessary vs surgery for prolapse

Many people try non-surgical options first. Surgery is a shared decision when symptoms are troublesome.

Preparing for your surgery

• Make sure you understand which part of the vagina is prolapsed and which repair is planned.
• Ask whether non-surgical options (physiotherapy, vaginal oestrogen, a pessary) have been tried or would be reasonable first.
• Discuss whether mesh is being proposed at all — for prolapse this is now restricted in the UK — and ask for a decision aid.
• If a vaginal hysterectomy is part of the plan, understand that this ends periods and fertility.
• Stop smoking if you can, lose excess weight if advised, and treat constipation and any chronic cough, as these affect healing and recurrence.
• Tell the team about all medicines, especially blood thinners, and any health conditions.
• Arrange time off work, help at home and a lift home, as you cannot drive for a while.

What happens

Most prolapse repairs are done through the vagina under general or spinal anaesthetic, so there is usually no cut on the tummy and no external scar. Some operations, such as those that lift the womb or the top of the vagina, may be done by keyhole or through the abdomen.

The surgeon supports the dropped organ and tightens the weakened tissue, using stitches in your own tissue. UK guidance recommends repairing the front and back vaginal walls without mesh. The vagina may be lightly packed and a catheter placed to drain urine for a short time.

Afterwards you wake in recovery and may have some vaginal bleeding like a period. Many people go home the same day or after a short stay. The team will explain wound care, how to avoid straining, and the warning signs to watch for before you leave.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

Two things matter most. First, prolapse can come back — around 25 to 30 in 100 women have a prolapse again in the future — so surgery improves symptoms but cannot promise a permanent cure. Second, the UK has a difficult history with vaginal mesh for prolapse: because of serious, sometimes life-changing complications, its use was heavily restricted in 2018, and most prolapse repairs now use your own tissue. If mesh is ever suggested, you should be given a decision aid, understand why, and be referred to a specialist centre. Ask your surgeon about your personal recurrence risk and exactly what is being used in your repair.

Published figures to discuss

Outcomes vary with the type and severity of prolapse, the repair used, and factors such as weight, cough and constipation, so a single success rate can mislead. The most important sourced figure is that prolapse recurs in around 25 to 30 in 100 women after surgery. Where mesh has been used in the vagina, complications such as mesh wearing through the vaginal wall have been reported in up to around 1 in 10 women, which is part of why its use is now heavily restricted in the UK.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery usually takes several weeks. Avoiding heavy lifting, straining and constipation in the early weeks gives the repair the best chance to heal and last.

• Period-like bleeding or discharge for a few weeks
• Some discomfort and a feeling of swelling in the vagina
• A temporary change in how it feels to pass urine or open the bowels
• Tiredness that improves week by week
• Dissolvable stitches that may come away as small threads over a few weeks

Aftercare

• Avoid heavy lifting, straining and strenuous activity for several weeks.
• Keep your bowels soft with fluids, fibre and laxatives if advised, to avoid straining.
• Use sanitary pads (not tampons) for bleeding, and keep the area clean and dry.
• Avoid sex until about 6 weeks and your team confirms healing is complete.
• Do not drive until comfortable, off strong painkillers, and able to do an emergency stop.
• Continue pelvic-floor exercises long-term to support the repair.
• Keep follow-up appointments, including the recommended review after surgery.

• Several weeks off work arranged, with help at home for the first days
• A lift home and someone to help in the first days
• Laxatives, fibre and plenty of fluids to keep bowels soft
• Sanitary pads (not tampons) for bleeding
• A plan for the 6-month review (and mesh check if mesh was ever used)
• The clinic's contact details and out-of-hours number saved

Scars and how they heal

Most prolapse repairs are done through the vagina, so there is usually no scar on the tummy and no visible external scar — the stitches are inside the vagina and usually dissolve. Some operations that lift the womb or the top of the vagina (such as sacrocolpopexy) are done by keyhole or through the abdomen and leave small or one larger tummy scar. Inside the vagina, healing leaves internal scar tissue that can slightly change vaginal shape or sensation; this is usually minor but can affect comfort during sex.

⚠ Get urgent help if…

• A hot, swollen, painful calf, or sudden breathlessness or chest pain (possible blood clot — call 999)
• Heavy vaginal bleeding, or bleeding that soaks pads quickly
• A high temperature, feeling very unwell, or offensive vaginal discharge (possible infection)
• Being unable to pass urine, or pain and burning when passing urine
• Severe or worsening pelvic or tummy pain not eased by your painkillers
• If mesh was used: persistent pelvic or vaginal pain, pain during sex, or a partner feeling the mesh — seek specialist review

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

For the right person, prolapse repair can relieve the bulge and the heavy, dragging feeling, and improve bladder, bowel or sexual symptoms caused by the prolapse, improving quality of life once healing settles.

What it cannot do is guarantee the prolapse will never return — around 25 to 30 in 100 women have a prolapse again in the future, sometimes in a different part of the vagina. It also does not always cure every bladder or bowel symptom, and sometimes new symptoms appear. A good surgeon explains realistic expectations and shares the decision with you.

Many people get lasting relief, but prolapse repair is not always permanent. Recurrence is more likely if you are overweight, have a long-term cough, are constipated and strain, or do heavy lifting, so managing these helps protect the repair. Pelvic-floor exercises and avoiding straining are worthwhile for the long term. Some people eventually need a pessary or further surgery.

Combining with other procedures

Prolapse repair is sometimes combined with other procedures — for example a vaginal hysterectomy for uterine prolapse, repair of more than one vaginal wall, or treatment for urinary leakage. Combining procedures is a shared decision; each part adds its own risks and recovery, so it should be planned, not assumed.

Follow-up & long-term care

UK guidance recommends a review around 6 months after prolapse surgery, including a vaginal examination, and if mesh was ever used, a check for mesh exposure. You should also have earlier review of healing and any wound problems. Report persistent pain, bleeding or new bladder or bowel symptoms, and seek specialist review for any suspected mesh complication.

• Continue pelvic-floor exercises long-term to support the repair.
• Manage weight, constipation and any chronic cough to lower the chance of recurrence.
• Avoid repeated heavy lifting and straining where possible.
• Attend the recommended 6-month review, and a mesh check if mesh was used.
• Seek review if a bulge, or new bladder or bowel symptoms, return.

Revision and secondary surgery reality

• Because prolapse can return, some people need a pessary or further surgery later.
• A new prolapse can develop in a different part of the vagina from the one that was repaired.
• New bladder symptoms can appear after surgery and sometimes need their own treatment.
• Mesh-related complications can require specialist surgery, which can be difficult.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• Clear written advice on activity, avoiding straining, driving and when sex is safe.
• Active measures to prevent blood clots, with advice on warning signs.
• A named contact and out-of-hours route for problems such as bleeding, infection or urinary retention.
• The recommended review around 6 months, with a vaginal examination and a mesh check if mesh was used.
• Support to continue pelvic-floor exercises and manage recurrence risk factors long-term.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The surgeon's fee and the complexity of the repair
• The anaesthetic and the anaesthetist's fee
• Which and how many repairs are done, and theatre time
• Whether the operation is vaginal, keyhole or abdominal
• The length of hospital stay
• Follow-up appointments, including the recommended 6-month review
• How any complications or repeat surgery are covered

• The surgeon's and anaesthetist's fees
• The hospital/theatre fee and expected length of stay
• Exactly which repairs are included
• Whether any mesh would be used and, if so, the referral pathway
• Follow-up appointments, including the 6-month review
• What happens, and what it costs, if the prolapse returns or a complication occurs
• The cancellation policy

On the NHS? Prolapse repair is commonly available on the NHS when symptoms warrant it; private care is sometimes used for a quicker appointment, choice of surgeon, or a second opinion.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• Which part of my vagina is prolapsed, and exactly what does the repair involve?
• Have I tried, or should I try, non-surgical options like physiotherapy or a pessary first?
• Is any mesh being used, and if so, why, and will I be referred to a specialist centre?
• What is my personal chance of the prolapse coming back?
• How might this affect my bladder, bowel and sex life?
• What follow-up will I have, including the 6-month review?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for vaginal prolapse repair

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: RCOG — Pelvic organ prolapse NICE NG123 — Urinary incontinence and pelvic organ prolapse in women: management NICE NG123 — Patient decision aid: surgery for uterine prolapse NHS — Pelvic organ prolapse

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.