A Week-by-Week Guide to Prolapse Surgery Recovery

There's no way around it — recovering from prolapse surgery takes time. While recovery timelines can differ from person to person, based on many different factors, you can generally expect it to take between 2 to 6 weeks.

Doctors tyipcally recommended that you take two full weeks off of work following your surgery. Of course, recommendations and reality are two different things. Not everyone has the luxury of paid medical leave. And caring for young children doesn’t stop when you’re recovering from surgery, either. If you don't have two weeks to dedicate to rest and healing, get as much help or support as you can, especially during the first few days after surgery.

To help you think through what you'll need and plan ahead, we've put together a week-by-week guide to prolapse surgery recovery, followed by some must-know information about prolapse and alternatives to surgery, if you're still considering your treatment options.

For more expert guidance, consider booking a visit with a pelvic floor physical therapist who can ensure that you're healing properly, manage any pain that might come up, and support your bowel, bladder, and sexual health. You don't have to go through this alone!

You Week-by-Week Recovery Guide

Note that the following post-op tips and guidelines are not personalized to you. Follow your doctor's instructions and listen to your body.

Prolapse Surgery Recovery: The First Few Days

You'll likely be sent home within just a few hours of surgery. As you recover from anesthesia, and adjust to any prescribed pain medications, driving is a risk you don't want to take. Arrange for someone to help drive you home.

In the first days after surgery, you’re going to want to focus on resting, following your doctor's post-op instructions, and protecting your incisions to allow for proper healing.

Moving around: You will be able to get up and walk around the same day as your surgery, but start with shorter distances to see how your body responds. You can return to easy self care activities (such as showering, dressing yourself, and simple cooking) the day after your surgery if you feel up to it.

Bowel health: Your bowel function will likely be disrupted for a few reasons after surgery. The after effects of anesthesia, disruption of your pelvic organs, and post-op pain medications can all add up to constipation and difficult bowel movements after surgery. And this may make it feel a little scary during the first few poops after surgery.

If you struggle to perform a bowel movement within a day or two of surgery, you may want to speak with your doctor about the possibility of using laxatives at first to help avoid constipation. Here are a few tips to help:

• Stay hydrated: Everyone’s hydration needs are different, but try and drink around half you weight in ounces of water each day.
• Eat foods full of fiber: And take stool softeners as needed so that your stool is soft and easy to pass.
• Push safely: During bowel movements it’s important to take your time, use slow deep breaths to relax your pelvic floor as you gently push. Avoid bearing down.

Exercises to try:

• Ankle pumps: In the first few days, you may not feel up to moving around much, so ankle pumps can help with circulation as you rest. To do them, point and flex your toes 10 to 20 times, once every hour. You can do this will sitting or lying down.
• Deep breathing: Sit upright and take a deep breath to the bottom of your lungs. Allow your belly to rise and feel your lower ribs move outwards. Repeat these 10 times per hour. Breathing will help to gently mobilize your pelvic floor and abdominals, and encourage your lungs to fill which is especially important after general anesthesia.
• Walking: Short walks in and around your home as permitted. This will help encourage blood flow, minimize swelling, and support healing.

Make sure you don’t overdo it in the early days – your body needs time to heal and regain its strength. If you’ve had laparoscopic surgery, you may feel bloated and uncomfortable from the gas that is used to inflate the abdominal cavity. This can be eased with walking but may take a few days to completely be eliminated by your body.

Prolapse Surgery Recovery: Weeks 1 to 2

About a week after surgery, you should begin to feel a little more like yourself, although you might still feel fatigued and sore. Be patient. While you can begin to walk more, you should avoid vigorous exercise, lifting, and straining. You will likely also need to continue to avoid sex for several weeks after surgery.

Exercises to try:

• More walking. Gradually introducing more movement is an important part of healing. Start with short, slow walks and begin to walk a little farther as your energy and stamina return.
• Breathing exercises. Continue to do regular breathing exercises. Slow, deep breathing exercises are a great way to relax the body and help coordinate pelvic floor muscle activation.
• Pelvic floor exercises. The pelvic floor muscles act as a sling to support the pelvic organs. It’s important to begin strengthening the pelvic floor soon after surgery to ensure these muscles return to their optimal strength and do not weaken after surgery.
• Abdominal exercises. You should start to do gentle abdominal exercises within the first few days after your operation. Begin by gently contracting and relaxing your abs while you’re resting in bed. Then progress to lifting each leg individually with your core engaged, and then both legs together.

Prolapse Surgery Recovery: Weeks 3 - 4

Many of you will be returning to full-time work and/or parenting duties now, so it’s important to think about your body mechanics, posture, and muscle recruitment as you begin to return to normal life. If you haven’t already, now is a good time to see a PFPT to help guide you through your recovery process.

Exercises to try:

• Improving strength and endurance. Now that the early stages of wound healing are behind you, it will be good to get your body stronger and moving more normally again. While continuing to follow your post-surgical recommendations try walking a little farther and maybe even lifting a little bit more. Some people might be cleared to lift more than 15 lbs by this point — but that doesn’t mean you should. Start with smaller amounts and see how your body (and your pelvic floor) responds.
• Pelvic floor exercises. Continue with pelvic floor exercises, pairing movement with pelvic floor engagement during daily tasks.
• Abdominal exercises. Continue to progress your abdominal exercises.

Prolapse Surgery Recovery: Week 5 to 6

This phase is about a slow and gradual return to your normal. By now, you may be feeling almost 100% with daily activities, but you may not have pushed yourself to do more yet. Now is the time to start preparing your body for more — carefully.

Prolapse Surgery Recovery: Week 6+

• Post-op follow-up. Usually there is a 6-week post-op follow up appointment with your surgeon. They will look over your incisions, ask about any symptoms and assess the success of your surgery. Keep in mind that these appointments usually focus on your self-reported information and a very brief examination. We recommend you write down any questions or symptoms you notice prior to your appointment. Things move quickly once you’re face-to-face with your doctor, so this will ensure you have all your questions answered before you leave.
• Physical therapy. Whether or not your doctor recommends you see a PFPT, it’s worth asking if you should. Like any major surgery, a guided and personalized recovery is the best way to ensure you are recovering in a healthy and appropriate way. If you are a runner, parent, or just hoping to become stronger during your recovery, a PT can also help you reach your specific personal and fitness goals.
• Low-impact workouts. If all looks and feels good, you may be cleared to return to low-impact exercise.

What Not to Do After Prolapse Surgery

Post-surgical restrictions — what you should not do after surgery — may vary based on which surgery you have, but they generally include:

• Avoiding insertion of anything into your vagina for 6 weeks, including tampons or sex.
• Refraining from lifting items heavier than 15 pounds for 2 to 6 weeks.
• Avoid high-intensity exercises like running, aerobics, or weightlifting during your initial recovery period.

When to Reach Out to Your Doctor

While rare, it’s important to keep in mind the signs of complications from surgery. If you have any of the below symptoms or you just feel like something is not right, contact your doctor immediately:

• Severe pain that does not improve or worsens
• Signs of infection, such as fever, chills, or spreading redness around your incision site
• Heavy vaginal bleeding (light bleeding or spotting is normal)
• Symptoms of a urinary tract infection (UTI), such as pain during urination, foul-smelling urine, blood in your urine, or a frequent urge to urinate

More About Prolapse Surgery

If you haven't yet had pelvic organ prolapse surgery and are still considering it, here's some information to help you decide. As with all surgeries and treatments, prolapse surgery is not guaranteed to be effective and can come with some risks.

What is Prolapse Surgery

Pelvic organ prolapse surgery is a procedure done to re-establish pelvic organ support. It can help reposition organs, resolve symptoms, and help you to get back to feeling confident and enjoying your life again.

According to the American College of Obstetricians and Gynecologists, there are two main categories of prolapse surgery:

• Obliterative surgery, which is done to narrow or close the vaginal cavity to help prevent organs from lowering into the vagina, is not very common. Because the vagina is narrowed or closed, this type of surgery may limit your ability to have penetrative sex or become pregnant in the future.
• Reconstructive surgery, which is the most common type of prolapse surgery, includes a variety of different pelvic surgeries meant to repair damaged tissues, and restore pelvic organs to their original positions. These surgeries are usually performed laparoscopically, requiring only small incisions through the abdomen or vaginal area.

The most common types of reconstructive surgeries include:

• Anterior colporrhaphy (front vaginal wall repair)
• Posterior colporrhaphy (back vaginal wall repair)
• Sacrocolpopexy (vaginal vault lift with mesh)
• Sacrohysteropexy (lift of the uterus with mesh)
• Sacrospinous fixation (vaginal vault lift using the sacrospinous ligament)

What to Expect from Pelvic Organ Prolapse Surgery

Pelvic organ prolapse surgery has become one of the most effective ways to treat extensive POP, providing a high rate of long-term symptom reduction and improvement in quality of life.

No matter which surgery you have, it’s important to understand that it is a major surgery that can take a physical toll and requires temporary lifestyle adjustments and gradual rehabilitation for proper recovery — especially for those who are newly postpartum. But it can help to learn about what to expect before, during, and after prolapse surgery to set you up for success in your recovery.

Preparation for Prolapse Surgery

Most prolapse surgeries are minimally invasive and performed under general anesthesia. You will work with your surgeon to develop a detailed plan before the procedure. The surgery is usually done laparoscopically and typically lasts between 30 minutes and 4 hours, depending on the complexity.

In preparation for the procedure, your surgeon may access the pelvic area in one of three ways: through the vagina with no external incisions, laparoscopically with several small abdominal incisions, or through one larger abdominal incision. The chosen method depends on the specific procedure, your anatomy, and any previous surgeries.

During the surgery, the urogynecologist will repair the prolapsed area and may also perform additional procedures to strengthen and secure the pelvic floor musculature. These could include bladder repair, adding surgical mesh for organ support, or performing a hysterectomy to remove the uterus.

Make sure you discuss any concerns with your surgeon prior to surgery so you know what to expect based on your own unique medical history.

Non-Surgical Treatment for Pelvic Organ Prolapse

Not everyone with pelvic organ prolapse will require surgery to resolve their symptoms. Two-thirds of women with POP will opt for conservative (non-surgical) treatments. Which treatment is best for you can depend on things like the severity of your prolapse, health and medical history, and personal preferences. Your care team, which may include an OBGYN, urogynecological surgeon, and pelvic floor physical therapist, will help you determine the best treatment options for you.

Pelvic Floor Physical Therapy for Prolapse

For some, pelvic physical therapy (PFPT) may be all you need to treat your POP. It is evidence-based, and for many, a very effective treatment option. A PFPT can perform a complete assessment and provide you with a personalized treatment plan that may include:

• Stretching and strengthening exercises
• Manual therapy to address muscle tension
• Pelvic floor muscle coordination training
• Breathing exercises
• Lifestyle and behavioral strategies
• Body mechanics training

They will also address any bowel or bladder symptoms (like constipation or difficulties emptying your bladder) that could be contributing to your symptoms. Most importantly, they will also provide you with more information about your diagnosis, your anatomy, and take into consideration your medical history, fitness goals, and any other life limitations that may impact your treatment plan. A PFPT will also answer any questions you have, providing you with much-needed support as you navigate your diagnosis.

In addition to PFPT, non-surgical treatments may include vaginal pessaries, local estrogen treatment, and lifestyle adjustments (strategies to find a comfortable weight, constipation treatment, and adjustments to lifting techniques, for example). Often, these treatments are combined for full recovery.

If you have more questions or concerns about your symptoms or the prospect of prolapse surgery, we're here for you at Origin! Don’t hesitate to make an appointment.