Pelvic Organ Prolapse

Symptoms of pelvic organ prolapse can vary depending on which organ is affected and how severe the prolapse is. 

Common symptoms include:

• a feeling of heaviness, pressure, or dragging in the pelvis

• a bulge in the vagina that you can see or feel

• a sensation of something “coming down” or “falling out” of the vagina

• discomfort during sex

• difficulty inserting or keeping a tampon in place

• problems passing urine, such as passing urine more frequently and urgently, or feeling that the bladder isn’t emptying fully

• constipation or incomplete bowel emptying

• recurrent urinary tract infections

• lower back or pelvic pain

Pelvic organ prolapse develops when the pelvic floor muscles and connective tissues become weakened and overstretched, and so are unable to properly support the organs. 

Common causes include:

• pregnancy and childbirth – vaginal delivery can stretch and weaken the pelvic floor, particularly after a long labour, or assisted delivery (forceps or vacuum)

• menopause – reduced oestrogen levels affect the elasticity of supporting tissues

• ageing – the pelvic muscles naturally lose tone and strength over time

• pelvic surgery or hysterectomy – can alter the support structures in the pelvis

• chronic coughing or constipation – causes repeated straining and pressure on the pelvic floor

• heavy lifting – can worsen pressure on weakened muscles

• obesity – increased abdominal pressure contributes to pelvic floor strain

• genetic factors – some women are born with weaker connective tissue

Certain health conditions, including joint hypermobility syndrome, Marfan syndrome and Ehlers-Danlos syndrome, can also increase the risk of having pelvic organ prolapse.

At your consultation, your specialist will begin with a detailed discussion about your symptoms, medical history, and any pregnancies or surgeries you’ve had. An internal pelvic examination is usually done to see which organs are affected and to check the stage of prolapse.

You may also be offered:

• ultrasound or MRI to evaluate the pelvic floor and supporting structures

• urodynamic testing if you have urinary symptoms

• pelvic floor assessment by a specialist physiotherapist

In cases where there are no symptoms, pelvic organ prolapse is often discovered during a routine internal examination, such as a cervical smear.

While it’s not always possible to prevent prolapse, the following steps can reduce your risk or stop it from worsening:

• practice regular pelvic floor exercises before and after pregnancy

• maintain a healthy weight

• avoid straining during bowel movements and treat constipation early

• stop smoking to prevent chronic coughing

• avoid lifting heavy objects where possible

• seek help for any persistent pelvic pressure, bulging, or urinary issues

If left untreated, pelvic organ prolapse can lead to:

• persistent pelvic discomfort and pain

• difficulty with urination or bowel movements

• recurrent urinary tract infections

• sexual discomfort or pain

• worsening prolapse 

• emotional distress, low self-esteem, or anxiety related to symptoms

Early assessment and treatment in our Women’s Health centre can help prevent these complications and improve your comfort and quality of life.

Following your diagnosis and any further tests, your gynaecologist will make a treatment plan tailored to you. Treatment options will vary depending on the severity of the prolapse. For many women, symptoms improve with lifestyle changes and non-surgical options, but sometimes surgery is necessary. 

Lifestyle changes that can help reduce strain include: 

• losing excess weight

• managing constipation

• avoiding heavy lifting

• stopping smoking

• treating any chronic cough

Non-surgical treatments may include: 

• pelvic floor exercises (Kegels) to strengthen the muscles that support the pelvic organs

• pelvic floor physiotherapy – guided therapy and biofeedback to ensure exercises are done correctly and effectively

• vaginal oestrogen cream or pessaries to help improve tissue strength and elasticity, especially after menopause

• vaginal pessary – a small silicone device inserted into the vagina to support the organs and reduce symptoms

Surgical options include: 

• pelvic floor repair (colporrhaphy) to strengthen the vaginal walls

• surgical repair of the prolapsed organ

• uterine suspension – where the uterus is attached to other structures within the pelvis 

• hysterectomy –  if the uterus is prolapsed and other treatments are unsuitable

At Welbeck, our gynaecologists are specialists in minimally invasive and reconstructive pelvic surgery. They’ll take time to understand your symptoms and goals, and use the latest techniques to help you feel comfortable and confident again.

At Welbeck, our gynaecologists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment.