Prolapse Treatment in Manchester

Overview

a woman who may or may not have a prolapse

Pelvic organ prolapse is common, and treatment is not always necessary. Many women have some degree of prolapse without significant symptoms, and in these cases, reassurance alone may be all that is needed

Mr David Iles is a consultant urogynaecologist in Manchester specialising in the assessment and treatment of pelvic organ prolapse. Consultations are available at St Mary’s Hospital and privately at The Alexandra Hospital in Cheadle, Cheshire.

When prolapse does cause symptoms, treatment is guided by how it affects your day-to-day life. Some women experience a feeling of heaviness or a vaginal bulge, while others notice discomfort, bladder or bowel symptoms, or difficulty with physical activity. The aim of treatment is not simply to correct anatomy, but to improve comfort, function, and quality of life.

Assessment and treatment planning

Choosing the right treatment depends on several factors, including your symptoms, examination findings, lifestyle, and personal preferences.
A specialist assessment typically includes:

  • A detailed discussion of symptoms and their impact on daily life
  • Examination to assess the type and severity of prolapse
  • Consideration of bladder and bowel function
  • Discussion of your goals and preferences

As part of your assessment, you may be asked to complete short questionnaires about your symptoms and how they affect your daily life. These help provide a clearer picture of your condition and guide treatment decisions.

Some women prefer to avoid surgery if possible, while others seek a more definitive solution. There is no single “right” approach — the best plan is one that fits you.

Understanding your symptoms

Specialist assessment

Treatment options explained

Personalised treatment plan

Treatment Options for prolapse

There are a range of effective treatment options available. These broadly fall into two categories: non-surgical and surgical


Non-surgical Prolapse Treatment

Non-surgical treatments are often appropriate as a first step and can provide excellent symptom relief for many women.

These treatments aim to improve symptoms and support the pelvic organs without the need for surgery.

These include:

  • Pelvic floor physiotherapy to strengthen the supporting muscles
  • Vaginal pessaries to support the pelvic organs
  • Lifestyle measures such as managing constipation and avoiding heavy straining

These approaches may be used alone or alongside other treatments, depending on your symptoms.


Learn more about non-surgical prolapse treatment 

Pelvic floor physiotherapy consultation with explanation of pelvic anatomy

Surgical Treatment for Prolapse

Surgery may be considered when symptoms are more severe, or when non-surgical treatments have not provided sufficient relief.

The aim of surgery is to restore the normal support of the pelvic organs and improve symptoms. There are several different types of operation, and the most appropriate option depends on the type of prolapse and your individual circumstances.

Prolapse can affect different areas of the pelvic floor, including the front (bladder), top (uterus or vaginal vault) or back (bowel), and surgery is tailored accordingly.

Most prolapse surgery is performed through a vaginal approach, although in some cases abdominal or minimally invasive (keyhole) techniques may be recommended. These approaches aim to provide durable support while maintaining normal vaginal function.

A range of surgical techniques are available, including native tissue repairs and, in selected cases, procedures involving mesh. The choice of approach is discussed carefully with you, taking into account your symptoms, examination findings and preferences.

Learn more about surgical options for prolapse →

Choosing the Right Treatment

There is no single “best” treatment for prolapse. The most appropriate approach depends on your symptoms, the type and severity of prolapse, and how much it affects your day-to-day life.

For some women, symptoms are mild and can be managed with reassurance or simple measures. Others may benefit from pelvic floor physiotherapy or a pessary, while some choose to consider surgery for more significant or persistent symptoms.

The decision is always individual. In many cases, more than one option may be suitable, and the choice depends on your preferences, lifestyle and priorities.

Key factors that help guide treatment include:

  • How much your symptoms affect your quality of life
  • Type and severity of prolapse
  • General health and level of activity
  • Whether you would prefer to avoid or consider surgery
  • Your personal goals and expectations from treatment

A careful discussion of these factors helps ensure that treatment decisions are made collaboratively, with a plan tailored to you and a clear understanding of the expected benefits and any limitations.

When to Consider Treatment

elvic organ prolapse is not a dangerous condition, and not all prolapse requires treatment. Many women with mild symptoms can be reassured and managed conservatively without intervention.

However, it is reasonable to consider treatment if symptoms are affecting your quality of life or becoming more noticeable over time.

You may wish to seek advice if you experience:

  • A sensation of a vaginal bulge or something "coming down"
  • A feeling of heaviness or discomfort, particularly later in the day
  • Symptoms that interfere with exercise, work or daily activities
  • Bladder symptoms such as leakage, urgency or difficulty emptying
  • Bowel symptoms such as difficulty opening the bowels or needing to strain
  • Discomfort during sexual activity
  • Uncertainty about whether your symptoms are normal or whether treatment might help

Early assessment can help clarify your options and, in some cases, simple measures may be enough to improve symptoms and prevent progression.

Why see a Specialist Urogynaecologist

Pelvic organ prolapse is a complex condition that can affect different parts of the pelvic floor and is often associated with bladder and bowel symptoms. Accurate assessment requires not only identifying the type of prolapse, but understanding how these symptoms interact and affect your daily life.

Urogynaecology is a subspecialty focused specifically on pelvic floor disorders, including prolapse, urinary incontinence and bladder dysfunction. This involves training to a subspecialist level, with deeper experience in both non-surgical and surgical treatment options.

While many general gynaecologists manage prolapse, more complex or persistent symptoms may benefit from subspecialist assessment.

In many cases, there is more than one possible approach to treatment. A specialist urogynaecologist can help guide these decisions by considering not only the anatomical findings, but also your symptoms, lifestyle and priorities. This ensures that treatment is individualised, and that all appropriate options — including conservative management and surgery — are carefully considered.

Seeing a specialist Urogynaecologist helps ensure:

  • Accurate diagnosis of the type and severity of prolapse
  • A comprehensive assessment of bladder, bowel and pelvic floor function
  • Clear explanation of all appropriate treatment options
  • Individualised, evidence-based recommendations
  • Access to both non-surgical and surgical expertise


Book a Consultation

If you are experiencing symptoms of prolapse, or would like advice about your treatment options, you can arrange a consultation for a full assessment and personalised management plan.