What is the recovery time for pelvic reconstructive surgery? How painful is prolapse surgery? What happens if prolapse is left untreated?

Pelvic floor dysfunction symptoms (like an overactive bladder) typically stay or become worse if they’re not treated. Instead of living with pain and discomfort, you can often improve your everyday life after a visit with your provider. The most common type of pelvic reconstructive surgery is that performed to correct pelvic organ prolapse.

Types of prolapse:

• Cystocele: Bladder falls into the vagina
• Enterocele: Small bowel falls into the vagina
• Rectocele: Rectum falls into the vagina
• Uterine Prolapse: Uterus falls into the vagina
• Vaginal Vault Prolapse: Upper portion of the vagina (the apex) descends into the vaginal canal

There are two main types of prolapse surgery:

• Transvaginal performed through the vagina.
• Transabdominal performed through the abdomen, usually laparoscopic or robotic via small incisions.

Both approaches are considered minimally invasive, have good success rates, and the approach is dependent on the preference of the patient as well as the surgeon. It should be a joint decision.

In general, prolapse surgery is performed either as an outpatient (go home the same day) or with a one-night hospital stay. For patients kept overnight in the hospital, a urinary catheter is usually left in place at the end of surgery and removed prior to discharge from the hospital. Patients are encouraged to get up and walk as soon as possible after surgery to prevent blood clots or lung problems. Most surgeons require a period of 6-8 weeks of pelvic rest, meaning nothing in the vagina (tampons, douches) and no vaginal penetrative intercourse.

Light exercise such as walking is encouraged. Heavy exercise, such as heavy weightlifting, should be avoided for 6 weeks. Although these approaches are major surgeries, pain levels are not as high as surgeries done through larger incisions. Most patients use a small amount of opioid pain medications in combination with ibuprofen and acetaminophen for the first 1-2 weeks after surgery.

Avoid constipation by increasing the fiber content in your diet, avoid taking pain medications as much as you can, and use stool softeners. Straining during bowel movements can place undue pressure on your reconstructive surgery before complete healing.