What is prolapse?

Prolapse simply means that something has dropped or fallen out of its normal place. In gynaecology, this term is used when you notice a bulge in your vagina. This bulge might appear on the front wall, the top (where your womb is or the upper part of your vagina if you’ve had a hysterectomy) or the back wall. It’s very common for women who have given birth to experience a little prolapse, and in most cases, it doesn’t cause any problems or need treatment.

What causes prolapse?

Prolapse happens when the support structures in your pelvis weaken. This loss of support is most often due to changes in your pelvic tissues from the weight of pregnancy or from damage that happens when tissues are stretched or torn during childbirth

• If your tissues are very rigid, they might tear during a forceps or ventouse delivery

• If your tissues are more stretchy, they may not bounce back completely after childbirth

• Other factors, such as constipation, can put extra pressure on your pelvic floor and worsen the problem

After delivery, you may notice some temporary symptoms as your body heals, but once the tissues are damaged they rarely return completely to their pre-pregnancy state and may gradually deteriorate over time

How do you know if you have prolapse?

The most common sign of prolapse is noticing a bulge or lump in your vagina

• The bulge may be more noticeable later in the day

• It might become more apparent after exercise

• It may also become obvious when you strain, such as when you are on the toilet

• In many cases the bulge is “reducible” – meaning it can be pushed back into place

• Some women may also experience backache if the prolapsed tissue rubs against surrounding areas

Although prolapse can be uncomfortable, it usually does not cause significant pain

How can prolapse be treated?

There are several options available to manage prolapse. The treatment is tailored to your individual symptoms and needs

• Lifestyle changes: Losing weight if you are overweight, improving your diet to manage constipation, or treating a chronic cough can all reduce the pressure on your pelvic floor
• Pelvic floor physiotherapy: Strengthening your pelvic muscles can help support the organs and may improve symptoms, especially in milder cases
• Supportive devices: A pessary, which is a supportive ring inserted into the vagina, can help hold your pelvic organs in place if you prefer to avoid surgery. There are several types available and your healthcare provider will help you choose the best one for you
• Surgery: For more severe cases or if other treatments have not provided enough relief, surgery may be considered. Surgical options are customised to your age, symptoms and personal preferences – for example, if you wish to avoid a hysterectomy. Detailed information on the different surgical procedures is available on trusted urogynaecology resources

What to expect at your first appointment

At your initial appointment at Birmingham Gynaecology Clinic, your symptoms will be carefully assessed and you will undergo a thorough examination to confirm the type and degree of prolapse

• You may be asked to complete a bladder diary
• You might fill in a quality of life questionnaire to help us understand how your symptoms affect your day-to-day activities
• Further investigations such as an ultrasound or urodynamic tests might be recommended to give a clear picture of your condition

After your appointment, you will receive a personalised letter outlining your management options and the next steps, ensuring you are fully informed about your treatment choices.

Addressing concerns about mesh

We understand that many women have concerns about the use of mesh in prolapse surgery.

• Mesh is very rarely used in our procedures
• If a procedure that might involve mesh is recommended, you will receive a full explanation of the risks, benefits and alternatives
• You will only give your consent if you feel completely comfortable with the plan, and there are non-mesh options available in almost every case

Why choose Birmingham Gynaecology Clinic

At Birmingham Gynaecology Clinic, we are committed to providing you with high-quality, personalised care that meets your individual needs. Our experienced team uses the latest techniques and technology to ensure you receive the best possible treatment for prolapse. We take the time to explain all your options and support you through every step of your treatment journey, so you can feel confident in your care.

Contact us

If you have any concerns about prolapse or would like to discuss your treatment options further, please contact us today. We are here to help you understand your choices and take the first step towards imp