Pelvic organ prolapse is common, affecting 1 in 10 women over the age of 50 years. Mild prolapse often causes no symptoms and treatment is not always necessary.
Prolapse can affect quality of life by causing discomfort. You may also experience a feeling of heaviness or a dragging sensation in the pelvis which may get worse as the day progresses. It can also cause bladder and bowel symptoms and having sex may feel different.
Treatment choices for prolapse include physiotherapy, support pessaries or surgery.
Your choice of treatment will depend on how the prolapse affects your quality of life. Not everyone with prolapse needs surgery or any other form of treatment.
Treatment for prolapse aims to support the pelvic organs and helps to ease your symptoms. It does not always cure the problem completely and prolapse may return.
We encourage all women to make self-referral to physiotherapy. This can be done by filling in a referral form here:
Performing Pelvic floor exercises will help manage symptoms of pelvic organ prolapse. These needed to be done regularly and long term to have the desired effect.
It is important to manage any constipation symptoms.
Many women find that the use of vaginal oestrogen can be beneficial in managing symptoms of prolapse in peri and postmenopausal women with vaginal atrophy. Please do talk with your GP if you feel that this would benefit.
As part of our Women’s Health Hub, we offer support on the management of pelvic floor dysfunction including the fitting of vaginal pessaries. You may be referred to see a clinician regarding this.
A pessary is a plastic or silicone device that fits into your vagina to help support the pelvic organs. This can be an effective way of helping your symptoms.
A pessary is suitable for most people. You may choose this option if you are thinking about having children in the future, you do not wish to have surgery or you have a medical condition that makes surgery riskier. You may also choose to use a pessary while you are waiting to have surgery.
There are different types and sizes of pessaries, and your doctor or specialist nurse will advise which one will suit you best. Ring pessaries are most commonly used.
Identifying the correct pessary may take more than one attempt as there are many different sizes and shapes. Pessaries should be changed or removed, cleaned and reinserted every 4–6 months. This can be done by your doctor, nurse or you may be able to do this yourself.
Pessaries do not usually cause any problems but can sometimes cause infection, discharge, bleeding or ulceration. Very rarely, the pessary may get stuck. If you have any concerns, you should see your doctor. It is possible to have sex with certain types of pessaries in place, but you and your partner may occasionally be aware of it. Some women may choose to remove it before having sex and reinsert it afterwards.
Further information can be located here:
Should more expert care be needed, there is a Pelvic Floor team located at Derriford Hospital to which a referral can be made.