Vaginal prolapse
What is a vaginal prolapse? A prolapse is when the an organ moves and bulges out of the vagina. What are the different types of vaginal prolapse? Womb prolapse (uterine prolapse) Bladder prolapse Bowel prolapse Top of vagina prolapse What are the symptoms of vaginal prolapse? Heaviness and feeling uncomfortable in your vagina Feeling a bulge coming out of your vagina
What it is
Anterior prolapse (cystocele - bladder), apical prolapse (uterine or vault), and posterior prolapse (rectocele) commonly co-exist. Severity is staged 0-4 using the POP-Q system. The relationship between anatomical stage and symptoms is variable - decisions about treatment are symptom-led, not picture-led.
When this is relevant
- Dragging or heaviness in the vagina, worse at the end of the day.
- A visible or palpable bulge in the vagina.
- Difficulty emptying the bladder or bowel; sometimes needing to support the prolapse.
- Recurrent UTI or vaginal soreness from a prolapse outside the introitus.
- Sexual dysfunction or dyspareunia.
How we investigate
Pelvic examination with POP-Q staging, cough stress test for concurrent incontinence, ultrasound bladder scan for post-void residual volume.
Options at The Vesey
- Pelvic floor physiotherapy - first-line for stage 1-2 prolapse.
- Vaginal pessary - ring, Gellhorn or cube - effective and reversible.
- Topical vaginal oestrogen - particularly for post-menopausal women, improves tissue tolerance.
- Vaginal repair surgery - anterior, posterior or apical depending on the dominant compartment.
- Sacrocolpopexy or sacrospinous fixation for apical prolapse with completed family.
- Vaginal hysterectomy where uterine prolapse is the dominant feature.
Will my prolapse get worse if left untreated? +
Not necessarily. Many prolapses remain stable for years. However, activities that chronically raise intra-abdominal pressure — heavy lifting, chronic cough, constipation, obesity — tend to worsen symptoms. Pelvic floor physiotherapy and lifestyle changes can slow progression and significantly improve comfort.
Can I still exercise with a prolapse? +
Yes, with guidance. Low-impact exercise is generally safe and beneficial. High-impact or heavy-loading activities may worsen symptoms. A specialist pelvic floor physiotherapist can design an individualised exercise plan. Many women return to running and gym work with appropriate technique modification.
Is a ring pessary comfortable to wear? +
Most women find a correctly-sized ring pessary comfortable enough to forget it is there during normal daily activities. Initial fitting may require a couple of size adjustments. Topical vaginal oestrogen alongside pessary use significantly improves tissue comfort and reduces discharge.
What surgical options are available for prolapse? +
Surgery depends on the compartment involved: anterior repair for cystocele, posterior repair for rectocele, sacrospinous fixation or sacrocolpopexy for apical prolapse, and vaginal hysterectomy where the uterus is the dominant element. Mesh is no longer routinely used for primary vaginal repair in the UK following MHRA guidance.
Pricing at a glance
Initial consultation £260. Pessary fitting £180. Surgical pricing patient-specific. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to book
Book if your prolapse symptoms are bothering you, pelvic floor physio hasn't helped enough, or you are weighing surgical options and want a structured second opinion.
Cost and pathway
Initial consultation £260. Pessary fitting £180. Surgical pricing patient-specific.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our gynaecology team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
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Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
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