What is pelvic organ prolapse?
Pelvic organ prolapse occurs when the muscles and ligaments supporting the pelvic organs weaken, allowing the bladder, womb, bowel or top of the vagina to drop down and press into or bulge out of the vagina. It is very common: around half of women over 50 have some degree of prolapse, though many have no symptoms. Vaginal childbirth, the menopause, chronic constipation, heavy lifting and being overweight all increase the risk.
Diagnosis is made through a pelvic examination, usually by a GP, gynaecologist or specialist physiotherapist, sometimes with the woman standing or straining so the prolapse can be seen at its fullest. Further tests such as bladder studies are occasionally needed when urinary symptoms are prominent. Treatment ranges from physiotherapy to surgery.
Common symptoms
- A dragging or heavy feeling in the pelvis
- A bulge or lump in or at the entrance of the vagina
- Feeling like sitting on a small ball
- Urinary problems such as leaking or incomplete emptying
- Difficulty opening the bowels
- Discomfort or reduced sensation during sex
- Low backache that eases when lying down
How long will you wait?
Prolapse care involves both physiotherapy and gynaecology waiting lists, and because gynaecology is one of the most pressured NHS specialties, waits from referral to surgical repair commonly run to many months and exceed the 18-week standard in much of England.
Privately, you can typically see a consultant within 3–7 days, start physiotherapy or have a pessary fitted within 1–2 weeks, and undergo surgery within 2–6 weeks if appropriate.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Pelvic floor physiotherapy. Supervised pelvic floor muscle training is first-line treatment and can significantly improve mild to moderate prolapse symptoms.
- Vaginal pessary. A removable silicone device fitted in the vagina to support the prolapsed organs, changed or reviewed every few months.
- Lifestyle measures. Weight loss, treating constipation and avoiding heavy lifting reduce strain on the pelvic floor.
- Surgical repair. Operations to restore support to the vaginal walls or womb, or hysterectomy in selected cases, for symptomatic prolapse not helped by conservative treatment.
What does private treatment cost?
As a guide, a private consultation typically costs £200–£300, specialist pelvic physiotherapy £60–£110 per session, and surgical prolapse repair in the region of £5,500–£9,000 depending on the procedure.
Does health insurance cover pelvic organ prolapse?
Private medical insurance generally covers assessment and surgical repair of prolapse if symptoms began after the policy started; long-standing prolapse would normally be excluded as pre-existing. Physiotherapy is usually covered but often capped at a set number of sessions per year. Pessary replacement as long-term maintenance may be treated as ongoing management rather than acute treatment, so check your policy's position.
Frequently asked questions
Can prolapse get better without surgery?
Yes, particularly milder prolapse. Supervised pelvic floor muscle training over several months improves symptoms for many women, and a well-fitted pessary can relieve the bulge and dragging sensation entirely while avoiding an operation. Weight loss and treating constipation also help. Surgery is generally reserved for women whose symptoms persist despite these measures or whose prolapse is more advanced.
Is prolapse surgery safe, and does it last?
Prolapse repair is a routine operation with good outcomes for most women, though as with any surgery there are risks, which your surgeon should explain fully. Prolapse can recur over time — roughly one woman in four or five needs further treatment at some point — so maintaining pelvic floor strength and a healthy weight after surgery matters. Mesh is no longer routinely used in vaginal repairs in the UK.
Should I avoid exercise if I have a prolapse?
No — staying active is good for you and for your pelvic floor. It is sensible to limit very heavy lifting and high-impact activity that worsens your symptoms, but walking, swimming, cycling and pelvic-floor-safe strength work are all encouraged. A specialist pelvic health physiotherapist can tailor an exercise programme that protects the pelvic floor while keeping you fit.
Related guides
- Endometriosis
- Fertility Problems
- Heavy Periods (Menorrhagia)
- Ovarian Cysts
- Polycystic Ovary Syndrome (PCOS)
- Uterine Fibroids