We provide expert assessment of prolapse and incontinence and a full range of treatment options

The pelvic floor muscles are a group of muscles at the base of your pelvis that run from your pubic bone at the front of your body to your spine at the back. They support the organs within your pelvis: your bladder, uterus (womb) and bowel. When these muscles are weakened or stretched prolapse can occur. Prolapse can cause a sense of bulge, discomfort, urinary and bowel problems as well as sexual difficulties. 

Your pelvic floor muscles are important for bladder and bowel control and support

of your pelvic organs.    

You should exercise your muscles in two different ways:

1. Squeeze your muscles as strongly as you can and release. Repeat 10 times or until your muscles start to get tired. Try to do this 4-5 times daily.

2. Squeeze your muscles more gently and hold for 5 seconds. Release. Gradually increase the length of time that you hold for, up to 10 seconds as your muscles become stronger. Try to do 4-5 

times daily.

 A pessary is a removable device made of plastic or silicone that fits into your vagina to help support your prolapse.  It should ease your symptoms, but it will not cure the condition. The pessary may make you feel more comfortable or alleviate your symptoms completely. You may be able to empty your bladder or bowel more efficiently. The pessary can be used as a long term treatment or as an interim measure prior to surgery. 

Vaginal prolapse repair may consist of one or more of the following 

Anterior repair - an  incision is made in the front wall of the vagina and the underlying connective tissue is identified and strengthened with stitches.

Posterior repair - an  incision is made in the back wall of the vagina and the underlying  connective tissue is identified and strengthened with stitches.

Perineorrhaphy - the skin at the back of the opening to the vagina is incised and the muscles stitched together to narrow the entrance to the vagina and support the back wall of   the vagina. The stitches for this  will be visible on the outside.

Vaginal Hysterectomy -  the uterus and cervix are removed through the vagina (from below). There are no stitches on the abdomen,  but there will be stitches at the top of the vagina. The ovaries are usually checked at the time of a vaginal hysterectomy but are not usually removed if they are normal.

Sacrospinous colpopexy is sometimes required to lift the top of the vagina. It involves putting in extra stitches through a very strong ligament at the back of the pelvis close to the sacrum/lower part of the spine .

Many operations for vaginal prolapse are performed vaginally. Sometimes it is more appropriate to have an abdominal operation. Your consultant will have discussed the indications with you. This may have a beneficial effect on urinary urgency.

This is a major operation, performed under a general anaesthetic usually through a bikini line cut in the abdomen.

Cervical Sacropexy (CESA, if the uterus is present)

The uterus is removed with the cervix left behind. The permanent mesh is stitched to the remaining cervix and secured to the front of the sacrum (upper tail bone)

Vaginal sacropexy (VASA, if the uterus was previously removed)

This is a similar procedure but the permanent mesh is stitched to the vaginal stump since the womb has already been removed.