How is pelvic organ prolapse treated?

A clinician may examine the vaginal walls and ask how the bulge, pressure, bowel changes or urine leakage affect daily life. Mild symptoms may be monitored. Pelvic-floor physiotherapy can teach exercises and ways to coordinate the muscles during lifting, coughing and toileting. A vaginal pessary is a removable support placed in the vagina; it may need fitting, cleaning and follow-up.

Treatment also addresses factors that increase pressure, such as constipation, persistent coughing or heavy lifting. If a prolapse is more advanced or continues to interfere with comfort, sex, exercise, bladder or bowel function, surgery may be discussed. Pelvic-floor repair surgery and sacrocolpopexy are different surgical approaches, chosen according to the type and position of prolapse.

Arrange an assessment if you notice a vaginal bulge, dragging sensation or new urinary leakage. Keep a short record of when symptoms appear, activities that worsen them, bowel and bladder changes, and whether you hope to become pregnant. Ask about physiotherapy before starting unfamiliar exercises, especially if movement causes pain. Seek advice about constipation treatment, cough management and safe activity rather than stopping all movement.

Seek urgent medical help for severe or rapidly worsening pelvic pain, inability to pass urine, heavy vaginal bleeding, fever with feeling very unwell, or a prolapsed mass that is very painful, bleeding or cannot be gently returned. Contact a clinician promptly if a pessary causes persistent pain, foul-smelling discharge or bleeding.

Ask which compartment is affected, whether physiotherapy or a pessary fits your goals, how follow-up will work, and what recovery would involve if surgery is considered. Ask how treatment may affect urination, bowel movements, sex and future pregnancy.