Treatment of recurrent pelvic organ prolapse: options for conservative and surgical management

Recurrent pelvic organ prolapse is a pressing issue in modern gynecology due to its high prevalence, considerable impact on quality of life as well as frequent need for repeat interventions. Despite improvements in surgical techniques and conservative treatment methods, recurrence rates after primary repair remain significant and complicate the choice of optimal management. The incidence of repeat treatment varies depending on the type of previous surgery and duration of follow-up. Conservative management includes pessary use and pelvic floor muscle training, which are appropriate for patients with moderate symptoms or contraindications to surgery. Repeat reconstructive procedures are technically demanding and require careful consideration of defect location, characteristics of prior interventions, and patient comorbidities. Revision surgery following sacrocolpopexy is especially challenging due to mesh fixation features and the risk of intraoperative complications. Management strategy is determined by multiple clinical factors, including prolapse severity, patient age, comorbidities, functional needs, and expected long-term outcomes. Individualized treatment improves therapeutic effectiveness and may reduce the odds for further surgical interventions. Continued accumulation of clinical data is essential for clarifying prognostic factors and improving practical management recommendations.

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