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Urogynaecology · UK

Posterior repair - prolapse support, done properly.

A native-tissue repair of the back wall of the vagina - for a rectocele, a bulge, or difficulty emptying the bowel. No vaginal mesh, a consultant urogynaecologist, and the pessary-and-physiotherapy conversation up front.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private posterior repair costs in the UK.

Indicative ranges across our partner urogynaecology units.

In short

£4,500–£7,500, home day-case or one night.

Procedure Indicative range
Urogynaecology consultation only £250–£450
Posterior repair (posterior colporrhaphy) £4,500–£7,500
Posterior repair with perineal repair £5,000–£8,500
Combined anterior and posterior repair £6,500–£11,000
Posterior repair with vaginal hysterectomy £9,000–£16,000
Posterior repair with sacrospinous fixation £8,000–£14,000
Pessary fitting (non-surgical option) £200–£450

Prices vary by hospital, by the surgeon, by whether more than one compartment is repaired, and by whether a hysterectomy or apical support is done at the same sitting. Combined cases sit at the top of the range.

The problem

The whole pelvic floor, the right option, and no mesh by default.

Prolapse repair is where care quietly falls short - one compartment fixed while another is missed, surgery offered before a pessary, or over-tight repairs. We address all three.

  • Try the pessary and physiotherapy first

    Many women do well without surgery. We make sure conservative options have been properly offered before an operation is chosen.

  • Treat the whole vagina, not one wall

    A back-wall bulge often sits alongside a front-wall or apical prolapse. Missing another compartment is a common cause of recurrence.

  • Native tissue, calibre preserved

    In line with UK guidance we use your own tissue, not mesh - and take care not to over-tighten, which protects comfort and intimacy.

When it helps

When a posterior repair is the right step.

The situations we see most, plus the one red flag that means assessment for other causes first rather than a straight-to-surgery booking.

  • Posterior vaginal wall prolapse (rectocele)

    A bulge where the rectum presses into the back wall of the vagina - the main reason for a posterior repair.

  • Difficulty emptying the bowel

    Needing to strain, splint or press on the vagina to complete a bowel motion, caused by the pocket a rectocele creates.

  • A sensation of a bulge or pressure

    A feeling of something coming down, dragging or fullness in the vagina that worsens through the day or with standing.

  • Enterocele (small-bowel prolapse)

    A bulge higher in the back wall where small bowel descends - sometimes repaired at the same time as a rectocele.

  • Prolapse after childbirth or previous surgery

    Weakening of the back wall following vaginal births, or a prolapse that has returned after earlier repair.

  • A deficient or torn perineum

    A weak or gaping perineum, often after childbirth, repaired alongside the posterior wall to restore support.

  • Discomfort during intimacy from a bulge

    When a posterior wall bulge causes discomfort or a loss of support that affects sex, once other causes are excluded.

  • Red flag: bleeding, pain or a change in bowel habit

    New bleeding, pelvic pain, unexplained weight loss or a persistent change in bowel habit needs assessment for other causes first - not a straight-to-surgery booking.

Procedure options

The repair depends on which parts have prolapsed.

What each option involves - from a native-tissue posterior repair to combined and apical procedures, all without vaginal mesh.

  • Native-tissue posterior colporrhaphy

    The standard repair - the surgeon reinforces your own weakened back wall with dissolvable stitches, without using mesh. Reliable and widely recommended.

  • Site-specific fascial repair

    Rather than a midline plication, the surgeon finds and repairs the specific defect in the supporting fascia, aiming to preserve vaginal calibre.

  • Posterior repair with perineorrhaphy

    A perineal repair added to rebuild a weak or torn perineum, restoring the platform that supports the back wall.

  • Enterocele repair

    Closing off a higher bulge where small bowel descends, often combined with a posterior or apical repair.

  • Combined multi-compartment repair

    When the front wall (cystocele) or top of the vagina is also prolapsed, those are repaired at the same sitting for a durable result.

  • Posterior repair with apical support

    Adding a sacrospinous fixation or similar to support the top of the vagina, which is often the root of a recurrent bulge.

  • Repair alongside vaginal hysterectomy

    Where the uterus is also prolapsing, removing it vaginally and repairing the walls together addresses the whole problem.

  • Non-mesh, patient-first approach

    In line with current UK guidance, vaginal mesh is not used for routine prolapse repair; native-tissue techniques are the default.

Safety and recovery

What to expect afterwards - honestly.

Posterior repair is a well-established operation. The things worth planning are which compartments to repair, bowel care afterwards, and protecting the result with pelvic-floor work.

  • Anaesthetic and day-case reality

    Most posterior repairs are day-case or a single night under general or spinal anaesthetic, done vaginally with no abdominal incision - which keeps recovery comparatively gentle.

  • Bleeding, infection and the vaginal wound

    Some spotting and discharge are normal for a few weeks. Heavier bleeding, offensive discharge or fever need a same-day call; wound infection is uncommon and usually settles with treatment.

  • Bladder, bowel and rectal injury

    Injury to the rectum or bladder during dissection is rare in experienced hands and repaired at the time if it happens. The proximity of these structures is why specialist experience matters.

  • Pain during intimacy afterwards

    Over-tightening the repair can cause discomfort during sex. A site-specific technique and preserving vaginal calibre reduce this - we discuss it frankly beforehand.

  • Constipation and straining

    Straining threatens any prolapse repair. Stool softeners, fibre and fluids early on, and treating constipation properly, protect the result - this is part of the plan, not an afterthought.

  • Recurrence over time

    Prolapse can recur, particularly if the top of the vagina was not supported or if the tissues are inherently weak. Addressing all compartments and doing pelvic-floor work lowers the risk.

  • Clots and mobility

    DVT prophylaxis and early, gentle mobilisation reduce the small risk of clots. Call the same day for calf pain, swelling or breathlessness.

  • Lifting, exercise and return to activity

    Light activity within days, avoiding heavy lifting and high-impact exercise for around six weeks, and intimacy usually after the six-week review, guided by your surgeon.

  • Red flags after surgery

    Heavy vaginal bleeding, fever, severe pain, difficulty passing urine, or leakage of stool or gas from the vagina need the same-day team or A&E, not a routine call.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whether one compartment was repaired or several, the note the surgeon sends you keeps to the same shape.

A UK consultant urogynaecologist reviewing a patient’s operation notes

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the operation note and the recovery plan before your review, just ask.

  1. 01 Header

    Diagnosis and compartments repaired

    Why the operation was done, the grade of prolapse, and whether the posterior wall alone or other compartments were addressed.

  2. 02 Technique

    Repair and any additions

    Whether a native-tissue or site-specific repair was used, and whether a perineal repair, enterocele repair or apical support was added.

  3. 03 Findings

    What was found at operation

    The state of the tissues, any incidental findings, and whether a pack or catheter was used and when it was removed.

  4. 04 Impression

    Recovery plan and follow-up

    Read this first: lifting and exercise restrictions, bowel care, pelvic-floor physiotherapy, and when to resume intimacy.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Posterior repair for symptomatic prolapse is usually covered when medically indicated, subject to pre-authorisation.

Frequently asked

Everything we get asked about posterior repair.

Quick answers on alternatives, mesh, recovery, cost and intimacy.

  • What is a posterior repair (posterior colporrhaphy)?

    A posterior repair is an operation to fix a prolapse of the back wall of the vagina - usually a rectocele, where the rectum bulges into the vagina. Working through the vagina with no abdominal incision, the surgeon reinforces your own weakened supporting tissue with dissolvable stitches. It relieves the sensation of a bulge and can improve difficulty emptying the bowel.

  • Do I definitely need surgery?

    Not always. Many women manage prolapse well with a vaginal pessary, pelvic-floor physiotherapy, and simple measures such as avoiding constipation and heavy lifting. Surgery is usually considered when symptoms are bothersome and conservative measures have not helped, or are not wanted. We make sure those options have been properly weighed before you consent to an operation.

  • Will mesh be used?

    No. In line with current UK guidance, vaginal mesh is not used for routine prolapse repair. A posterior repair uses your own tissue (a native-tissue repair) reinforced with dissolvable stitches. Your surgeon will explain the technique and why native-tissue repair is the default.

  • How long is recovery?

    Most women go home the same day or after one night. Expect some spotting and discharge for a few weeks. Light activity returns within days, but heavy lifting and high-impact exercise are avoided for around six weeks, and intimacy usually resumes after the six-week review. Avoiding constipation and straining throughout is key to protecting the repair.

  • How much does a private posterior repair cost in the UK?

    Roughly £4,500–£7,500 for a posterior repair alone, £5,000–£8,500 with a perineal repair, and £6,500–£11,000 for a combined anterior and posterior repair. Repairs done alongside a vaginal hysterectomy or apical fixation are typically £8,000–£16,000.

  • Will it affect my sex life?

    The aim is to relieve the bulge and improve support, which often helps. The main risk is discomfort if the repair is made too tight, which is why an experienced surgeon preserves vaginal calibre and uses a site-specific technique where appropriate. We discuss this openly before surgery so your expectations and goals are clear.

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