Pelvic organ prolapse causes distressing vaginal, bladder, bowel and sexual symptoms, and impaired quality of life for women worldwide. On examination, 40% of women over 50 years of age have prolapse, with symptomatic prolapse affecting 11% of women. An estimated 9.5% of UK women have prolapse surgery and 15.8% will require re-operation, with the annual cost of surgery in England alone being £72M. Recent concerns relating to surgical mesh complications and the rate of prolapse recurrence following surgery have, in combination, increased the focus on non-surgical options for prevention and treatment, such as supervised pelvic floor muscle training and vaginal pessary. The identification of modifiable risk factors for prolapse has also become important for the development of primary and secondary prevention strategies.

This State-of-the-Art Lecture will explore the evidence for the effectiveness of non-surgical interventions for prevention and treatment of prolapse, highlighting which of these are evidence-based and should be implemented, and the challenges of doing so.

View Suzanne Hagen's bio here