INTRODUCTION AND HYPOTHESIS: This committee opinion paper summarizes available evidence about recurrent pelvic organ prolapse (POP) to provide guidance on management. METHOD: A working subcommittee from the International Urogynecological Association (IUGA) Research and Development Committee was formed. The literature regarding recurrent POP was reviewed and summarized by individual members of the subcommittee. Recommendations were graded according to the 2009 Oxford Levels of Evidence. The summary was reviewed by the Committee. RESULTS: There is no agreed definition for recurrent POP and evidence in relation to its evaluation and management is limited. CONCLUSION: The assessment of recurrent POP should entail looking for possible reason(s) for failure, including persistent and/or new risk factors, detection of all pelvic floor defects and checking for complications of previous surgery. The management requires individual evaluation of the risks and benefits of different options and appropriate patient counseling. There is an urgent need for an agreed definition and further research into all aspects of recurrent POP.

Department of Obstetrics and Gynecology Charles University Prague Prague Czech Republic

Department of Obstetrics and Gynecology College of Medicine and Medical Sciences Arabian Gulf University Manama Kingdom of Bahrain

Department of Obstetrics and Gynecology Hampshire Hospitals NHS Foundation Trust Basingstoke Hampshire UK

Department of Obstetrics and Gynecology King Khalid University Hospital and College of Medicine King Saud University Riyadh Saudi Arabia

Department of Obstetrics and Gynecology Medway Hospital NHS Trust Medway Maritime Hospital Gillingham and University of Kent Canterbury Kent UK

Department of Obstetrics and Gynecology Royal Sussex County Hospital Brighton and Sussex University Hospitals NHS Trust and Brighton and Sussex Medical School Brighton BN2 5BE East Sussex UK

Faculty of Medicine University of Buenos Aires Buenos Aires Argentina

Genesis Health System Zanesville OH USA

South Warwickshire NHS Foundation Trust University of Warwick Coventry England UK

University of Greenwich London UK

Women's Pelvic Specialty Care P C University of New Mexico Hospital Albuquerque NM USA

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