Follow-up of Fertility, Contraception, and Pregnancy Outcomes After Pelvic Organ Prolapse Surgery

Abs tractAim: Pelvic organ prolapse (POP) is a common condition among parous and aging women.While surgical repair is effective, little is known about fertility, contraception, and pregnancy outcomes postoperatively.This study evaluates these aspects to inform preoperative counseling and reproductive planning.Methods: This retrospective observational study included 122 sexually active women aged 18-45 years with negative preoperative pregnancy tests who underwent POP surgery between January 2019 and September 2023.Data were collected from hospital records and follow-up calls and analyzed using SPSS. Results:The mean patient age was 39.94.4 years.The most frequent prolapse types were rectocele (68.9%) and cystocele (54.1%).Preoperatively, 54.1% of patients used no contraception, while 21.3% used intrauterine devices and 9.8% underwent bilateral tubal ligation (BTL) or bilateral salpingectomy (BS).Postoperatively, the percentage of individuals not using contraception dropped to 40.2%, and BTL/BS use rose to 20.5%.Two patients conceived postoperatively, both with favorable short-term outcomes.Postoperative complications were rare, with pelvic pain (8.2%) as the most common. Conclusion:Findings highlight a shift toward permanent contraception post-surgery, influenced by completed fertility and cancer prevention.Pelvic organ prolapse surgery, particularly uterine-sparing approaches, can preserve fertility in selected cases.However, early menopause or ovarian failure remains a risk.Pelvic organ prolapse surgery in reproductive-aged women requires individualized counseling on fertility and contraception.Surgical planning should include discussion of reproductive goals, and long-term follow-up is essential to monitor outcomes and support informed choices.