Private Assessment & Treatment for Pelvic Organ Prolapse
What Is Pelvic Organ Prolapse?
Pelvic organ prolapse is a condition in which the muscles and ligaments supporting the pelvic organs become weak or stretched, allowing the bladder, uterus or bowel to move down from their normal position and bulge into the vagina. It commonly develops after childbirth, during menopause or as the pelvic floor weakens with age.
According to the Royal College of Obstetricians and Gynaecologists (RCOG), around 1 in 10 women over 50 experience symptoms of pelvic organ prolapse. Some women have no noticeable symptoms, while others experience vaginal heaviness, pelvic pressure, a visible bulge or problems with bladder and bowel function.
Pelvic organ prolapse is not usually life-threatening, but it can affect everyday activities, sexual wellbeing and quality of life. Treatment depends on the type and severity of the prolapse and how much the symptoms affect you. Mild cases may only require monitoring, while pelvic floor physiotherapy, vaginal pessaries or prolapse repair surgery can help manage more troublesome symptoms.
Types of Pelvic Organ Prolapse
Pelvic organ prolapse can affect the bladder, uterus, bowel or vaginal walls. The main types include:
1. Cystocele (Bladder Prolapse)
Occurs when the bladder bulges into the front vaginal wall. Common symptoms include urinary leakage, frequent urination and difficulty emptying the bladder.
2. Rectocele (Bowel Prolapse)
Develops when the rectum pushes against the back vaginal wall, causing constipation, difficulty passing stools or incomplete bowel emptying.
3. Uterine Prolapse (Womb Prolapse)
Happens when the uterus moves down into the vagina due to weakened pelvic floor muscles. Symptoms include pelvic pressure, vaginal heaviness and a noticeable bulge.
4. Vaginal Vault Prolapse
Can develop after a hysterectomy when the upper vagina loses support. It may cause vaginal bulging, pelvic discomfort and bladder or bowel problems.
5. Enterocele (Small Bowel Prolapse)
Occurs when the small intestine pushes against the upper vaginal wall, causing pelvic pressure, fullness or discomfort, particularly after prolonged standing
Symptoms of Pelvic Organ Prolapse
Pelvic organ prolapse symptoms depend on which organ is affected and how far it has moved. Some women experience mild discomfort, while others notice symptoms that interfere with daily activities.
Common signs of pelvic organ prolapse include:
Pelvic heaviness: A dragging or pressure sensation in the lower abdomen or vagina.
Vaginal bulge: A noticeable lump or feeling that something is coming down.
Bladder problems: Urinary leakage, frequent urination or difficulty emptying the bladder.
Bowel difficulties: Constipation, straining or incomplete bowel emptying.
Pain during sex: Discomfort or pressure during intercourse.
Lower back discomfort: Pelvic aching that may worsen throughout the day.
Worsening symptoms: Increased heaviness after prolonged standing, lifting or physical activity.
What Causes Pelvic Organ Prolapse?
Pelvic organ prolapse develops when the pelvic floor muscles and supporting ligaments weaken, making it harder to keep the bladder, uterus and bowel in their normal positions. Pregnancy, childbirth and ageing are among the main contributing factors.
Common causes and risk factors include:
Vaginal childbirth: Difficult deliveries, larger babies or assisted births can stretch and weaken pelvic floor tissues.
Multiple pregnancies: Repeated strain on the pelvic floor may increase the risk of prolapse.
Menopause: Ageing and hormonal changes can affect pelvic tissue strength and support.
Chronic constipation: Frequent straining during bowel movements puts additional pressure on the pelvic floor.
Heavy lifting: Repeated strenuous lifting can increase pressure on weakened pelvic muscles.
Excess body weight: Additional weight places greater strain on pelvic organs.
Family history: Inherited differences in connective tissue strength may increase susceptibility.
Previous pelvic surgery: Certain procedures, including hysterectomy, may increase the risk of vaginal prolapse.
Not every woman with these risk factors develops prolapse. A gynaecological examination can help identify the type and severity of prolapse and guide suitable treatment options.
How Is Prolapse Diagnosed?
Pelvic organ prolapse is usually diagnosed through a pelvic examination and a review of your symptoms. At Gynaeaesthetics London, Mr Mohammad Masood will assess your medical history, bladder and bowel symptoms, and pelvic floor support to determine the type and severity of prolapse.
Additional tests may include:
Pelvic ultrasound: To examine the uterus, bladder and other pelvic structures when needed.
Urodynamic testing: To assess bladder function if urinary leakage or emptying difficulties are present.
MRI scan: Occasionally recommended for complex prolapse cases or when further assessment is needed before surgery
Treatment Options
Pelvic organ prolapse treatment depends on the type and severity of the condition, the symptoms you experience and your future pregnancy plans. Mild cases may not require immediate treatment, while more troublesome symptoms can be managed with non-surgical therapies or surgery. At Gynaeaesthetics London, Mr Mohammad Masood assesses your condition and discusses suitable treatment options based on your individual needs.
Pelvic Floor Rehabilitation
Pelvic floor physiotherapy is often recommended for mild to moderate prolapse. A supervised exercise programme helps strengthen the muscles supporting the bladder, uterus and bowel, which may improve pelvic pressure and discomfort. NICE recommends at least 16 weeks of supervised pelvic floor muscle training for women with symptomatic stage 1 or 2 prolapse.
Vaginal Pessary Fitting
A vaginal pessary is a removable silicone or plastic device fitted inside the vagina to support the prolapsed organs. It offers a non-surgical treatment option for women who wish to avoid or delay surgery. Regular follow-up appointments are important to check the fit, monitor vaginal health and manage any discomfort or discharge.
Vaginal Oestrogen Treatment
For women experiencing menopause-related vaginal dryness or irritation alongside prolapse, local vaginal oestrogen may be recommended. It helps improve the condition of vaginal tissues but does not correct the prolapse itself. Treatment suitability is assessed according to individual symptoms and medical history.
Pelvic Organ Prolapse Surgery
Surgery may be considered when prolapse symptoms significantly affect daily life and non-surgical treatment has not provided sufficient relief or is not preferred. The procedure depends on which pelvic organs are affected. Surgical options may include:
Anterior repair: Repairs the front vaginal wall to support the bladder.
Posterior repair: Strengthens the back vaginal wall to correct a rectocele.
Sacrocolpopexy: Supports the vaginal vault, usually following a hysterectomy.
Uterine suspension: Restores support to the uterus without necessarily removing it.
Before recommending prolapse repair surgery, Mr Masood will discuss the expected benefits, possible complications, recovery time and risk of recurrence. The aim is to help you make an informed decision about the treatment most appropriate for your symptoms and circumstances.
Why Choose Gynaeaesthetics London?
- Consultant-led care by Mr Mohammad Masood
- Full range of non-surgical and surgical treatment options
- Private pessary fitting and ongoing management
- Experienced laparoscopic prolapse surgeon
- No GP referral needed
- Same-week appointments available
- Clinics in Hornchurch, Brentwood, and Ilford
- Sensitive and discreet approach throughout
- Fully confidential from start to finish
- Consultations from £200