Your pelvic floor prolapse comprehensive guide

Written by: Mr Kostis Nikolopoulos
Edited by: Conor Lynch

In our latest article, highly revered consultant obstetrician and gynaecologist, Mr Kostis Nikolopoulos, explains what exactly pelvic floor prolapse is, what causes it, and reveals whether surgery is essential or not for patients suffering from the female-affecting condition.

What is pelvic floor prolapse and what causes it?

Pelvic floor prolapse is the descending of one or more of either the anterior vaginal wall, the posterior vaginal wall, or the uterus, or the top of the vagina in women who do not have a uterus.


In terms of causes, there are various risk factors such as genetics and childbirth. Childbirth, in particular, causes muscle and connective tissue injuries or damage. Other risk factors include the occupation of the woman, obesity, and chronic cough.


Is surgery essential for pelvic floor prolapse?

It depends on the degree of the prolapse. Some women have some small degree of pelvic floor prolapse and are asymptomatic, and will not require any surgery, and in most cases, probably will not require any treatment.


The treatment really depends on the symptoms presented. Some women suffer from a small descent of the bladder into the vagina and have significant symptoms, and so, will need to be treated.


The treatment options are either conservative (in mild degrees of prolapse) or surgery. In severe cases, the two options are generally either surgery or the inserting of certain devices into the vagina that can relieve the symptoms. Elderly women who are not fit for surgery are ideal candidates for the inserted devices.


Is pelvic floor prolapse surgery painful?

There are different types of surgery for pelvic floor prolapse. Generally, they are routine operations, and women tend to tolerate any pain very well. Recovery time depends on the surgery performed, whether it is a major surgery or not, and women should, of course, avoid any heavy lifting for some time after their operations.


Are there any side effects related to pelvic floor prolapse surgery?

Like any surgery, there are associated complications. However, the complication rates related to pelvic floor prolapse depends on many factors. First of all, if the woman only has pelvic prolapse of the bladder in the vagina, the complications rates are less than a patient who may have uterine prolapse and high-grade prolapse.


The complications are divided into two categories: the complications that can occur during the surgery or immediately after surgery, and the long-term complications. Long-term complications are extremely rare, and the rates of these complications depend on the surgical expertise and the operation that has been performed.


The complications that can arise immediately after surgery typically include infection, hematomas, and some difficulty to pass urine. These complications typically only last for a few days.


Long-term complications may include chronic pain and/or untreated symptoms due to unsuccessful treatment/surgery, which will mean that woman will have to undergo the surgery again not long after undergoing the initial unsuccessful surgery.


What are the main symptoms of pelvic floor prolapse?

There are a wide variety of pelvic floor prolapse symptoms. The most common ones include the following:

  • feeling of pressure or fullness in the pelvic area
  • painful sexual intercourse
  • urinary incontinence
  • increased urinary frequency
  • urinary retention
  • constipation
  • vaginal bleeding


What is the success rate of pelvic prolapse surgery?

We generally assess the outcome of the surgery either with examination to see if the anatomical structure has been restored, and through questionnaires, to see if patients were satisfied with the surgery. Generally speaking, prolapse surgery has very high success rates.


If you feel as though you may be suffering from pelvic floor prolapse, make sure you book an appointment with Mr Kostis Nikolopoulos today by visiting his Top Doctors profile.

By Mr Kostis Nikolopoulos
Obstetrics & gynaecology

Mr Kostis Nikolopoulos is an expert consultant obstetrician and gynaecologist based in Windsor and Slough, specialising in urogynaecology, pelvic floor prolapse and incontinence. He also has top experience in laparoscopic surgery and treating menorrhagia (abnormally heavy or prolonged periods) and fibroids. Mr Nikolopoulos practices at BMI The Princess Margaret Hospital in Windsor and the Parkside Suite at Wexham Park Hospital privately, as well as for the NHS at the same centre.

He performs various complex operations including laparoscopic/vaginal, abdominal  hysterectomy (uterus removal), pelvic floor repair (vaginal reconstruction), among many others. 

Mr Nikolopoulos is a highly-qualified professional with an MSc, an MA in high risk pregnancies and a PhD in Urogynaecology. He is also certified by the European Academy of Gynaecological Surgery with a diploma in endoscopy. After completing his training in obstetrics and gynaecology in 2016, he undertook a fellowship with the Royal College of Obstetricians and Gynaecology. Here he received advanced training in urogynaecology and vaginal surgery.

Mr Nikolopoulos also has a senior clinical fellowship in laparoscopic surgery, has conducted research projects on urinary incontinence and has had his work published in leading peer-reviewed publications and book chapters. Furthermore, he has participated in various national and international conferences. 

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