How to Reverse Pelvic Prolapse and Avoid Prolapse Surgery

Pelvic prolapse surgeryAre you trying to avoid pelvic prolapse surgery?

Are seeking to reduce your prolapse symptoms?

Would you like to reverse your prolapse repair?

Read on now for Pelvic Floor Physiotherapist answers to these questions:

  • Can pelvic prolapse be reversed without surgery? How?
  • Can non-surgical treatment relieve prolapse symptoms? How?
  • Will my prolapse worsen over time? How soon? How to avoid prolapse worsening?

Can Pelvic Prolapse be Reversed?

Yes! Pelvic prolapse can be treated and improve without surgery in some women.

Prolapse results from stretched and weakened supporting pelvic floor tissues, just like overstretching a piece of elastic.

Pelvic Organs

Your pelvic floor muscles should work to help support your pelvic organs (i.e. bladder, uterus and rectum). Women with prolapse have weak pelvic floor muscles1 so they have decreased internal support.

Recent scientific research2 showed that three months of pelvic floor muscle training reduced the severity of vaginal prolapse in some women with mild to moderate prolapse (i.e. pelvic prolapse sitting above the vaginal entrance rather than beyond).

Proven effective prolapse treatment2 includes:

The Knack Video

Watch ‘The Knack’ video now

  • Training the pelvic floor muscles to increase prolapse support (outlined below)
  • Learning The Knack exercise technique to reduce prolapse strain
  • Modifying lifestyle factors that worsen prolapse problems (e.g. straining with constipation, heavy lifting and inappropriate general exercise)

In women with more severe prolapse problems (i.e. prolapse protruding below the vaginal entrance) pelvic floor muscle training is less effective in reversing prolapse. These women are still likely to benefit from pelvic exercises, especially if they are undergoing prolapse surgery and are seeking to avoid repeat prolapse.

Can Non-Surgical Treatment Relieve Prolapse Symptoms?

Yes! The frequency and severity of pelvic prolapse symptoms can be relieved without surgery in some women.

Scientific research2 has shown that women can reduce how often they experience prolapse symptoms with pelvic floor muscle training. Some of the most common prolapse symptoms i.e. vaginal bulging and heaviness that are often the main indicators for prolapse surgery have also been reduced with pelvic floor muscle training.

How much Pelvic Floor Muscle Training for Results? pelvic floor muscles

Pelvic floor muscle training to reverse the stage of prolapse and relieve vaginal bulging and heaviness involves:

• Performing 3 sets (groups) of daily pelvic floor exercises
• Repeating your exercises 8-12 times in a row
• Contracting your pelvic floor muscles strongly with every exercise

If you are suffering from prolapse problems, pelvic floor exercises can help you take back some control over your body. These muscle training exercises cost you nothing and there are no adverse side effects if they are done correctly.

For more information about pelvic floor muscle training for prolapse refer to Prolapse Exercises by Pelvic Floor Physiotherapist Michelle Kenway

Additional strategies for alleviating prolapse symptoms:losing weight

Will my Pelvic Prolapse Worsen?

Unfortunately there is currently no way of predicting whether a woman’s pelvic organ prolapse will worsen over time or how quickly.There is no one rule fits all when it comes to prolapse worsening.

Some women don’t experience prolapse worsening over time, managing their prolapse and maintaining an active life. Others find that their prolapse worsens to the extent that they require repair surgery.

Pelvic organ prolapse does tend to progress as women increase in age3. This suggests that life-long prolapse management involving pelvic floor muscle training is important for women living with prolapse problems who are seeking to avoid prolapse surgery.

Key Points

  1. Pelvic floor muscle training is a scientifically proven effective non-surgical pelvic prolapse treatment for some women in the short-term at least.
  2. You may be able to avoid pelvic prolapse surgery with pelvic floor muscle training if you can relieve those prolapse symptoms that are the main indicators for repair surgery.

If you’re not sure about how to proceed with pelvic floor training to manage your pelvic prolapse then why not seek the guidance of a Pelvic Floor Physiotherapist?

prolapse exercisesABOUT THE AUTHOR, Michelle Kenway

Michelle Kenway is a Pelvic Floor Physiotherapist and author of Prolapse Exercises. This complete exercise guide is especially for women with prolapse and after prolapse surgery seeking to successfully train their pelvic floor muscles, exercise safely and protect their prolapse.


1 DeLancey JO, Morgan DM, Fenner DE, etal.(2007) Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse. Obstetrics & Gynecology;109:295-302.

2 Brækken, I. H., Majida, M., Engh, M. E., & Bø, K. (2010). Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. American Journal of Obstetrics and Gynecology, 203(2), 170-e1.

3 Hunskaar S, Burgio K, Clark A, et al. (2005)Epidemiology of POP. In: Abrams P, Cardozo L, Khoury S, Wein A, eds. Incontinence. Plymouth,UK: Health Publication Ltd; 290-8.


  1. Marieke says:

    Hi Michelle

    How long does it normally take for the muscles to strengthen adequately – i.e. for how long and how many sessions do you treat patients?
    Is a subjective improvement in symptoms from the patient’s point of view an adequate indicator of improvement, or which objective measures do you use?

    Kind regards
    (Physiotherapist in Namibia)

    • Michelle Kenway says:

      Hi Marieke

      The time for pelvic floor muscles to strengthen varies from one woman to the next.

      This can depend upon a woman’s:

      * initial pelvic floor muscle strength and function
      * ability to perform pelvic floor exercises using correct technique
      * adherence to home exercises

      The research indicates that women with weak pelvic floor muscles can require 5-6 months of regular pelvic floor exercises to regain pelvic floor strength and that changes start to occur within a couple of weeks of commencing pelvic floor strengthening.

      Subjective improvement in symptoms is one indicator that can be used if you’re not performing vaginal examinations to assess the pelvic floor muscles. Vaginal assessment of pelvic floor muscle strength and grading pelvic floor muscle function is one of the most accurate methods objective methods of quantifying improvement. Ultrasound and EMG are also used in Australia as objective measures of improvement however these methods are not available world-wide. Different cultural practices and norms mean than vaginal assessment of pelvic floor muscles is not carried out routinely in some countries. So I think it really comes down to what measures are available for you to use in your country Marieke.

      I hope this information is helpful.

      All the best

  2. lara boris says:

    How do I get this book

  3. Pelvic floor exercises aren’t good for everyone. I have a prolapse and at the same time my pelvic floor is in spasm, Pelvic Floor Dysfunction. Pelvic floor exercises like Kegels make it worse. I have been seeing a pelvic floor physical therapist to work on relaxing the muscles.

    I cringe every time I see people recommending exercises like these without the warning that for some women, they are harmful.

    • Michelle Kenway Physiotherapist says:

      Hi Mary

      You’re correct! Pelvic floor exercises need to be performed correctly with a contraction and then relaxation of the pelvic floor muscles. Sometimes the pelvic floor muscles can become too tight and spasm which can be painful and debilitating indeed and yes this is a risk for some ladies after pelvic floor surgery. If women with pelvic floor spasm do pelvic floor exercises, they can worsen their pelvic floor spasm. For the general population pelvic floor exercises are very important which is why most women with spasm are then retrained to do their pelvic floor exercises correctly including the relaxation.

      Wishing you all the best for your recovery & thank you for your reminder.


  4. Hi Michelle I had a prolapse once before it was due to constipation, it went away in no time, I have one now and also due to constipation.. I can sure feel my pelvis floor flexing? Is this a good sign and do u think I will recover quickly again?

    • Michelle Kenway Physiotherapist says:

      Hi Kristi

      Once the tissues prolapse they remain so for life – this happens because they are stretched beyond their elastic limits. Your pelvic floor muscles may have provided sufficient support to help you overcome this previously. Whether or not this can happen again depends upon the severity of your prolapse and how well your pelvic floor muscles support your pelvic organs so it will be wise to do pelvic floor exercises regularly life long.

      All the best

  5. Hi I have a Cleo discreet electronic pelvic floor exerciser & haven’t really used it yet. I now have the onset of a rectal prolapse & am wondering if it is safe to use the exerciser? Any advice?x

    • Michelle Kenway Physiotherapist says:

      Hi Chris
      Thanks for your question. My apologies I am not familiar with Cleo and its contraindications. If you read the instructions it should state whether it can be used with prolapse. Pelvic floor strengthening is important in managing rectal prolapse so this is worth following up. Maybe phone the manufacturers or distributors for more information.

  6. I would like a pamphlet on exercises for prolapse

  7. Dear MIchelle,
    Thank for this space and your time… I have a prolapse Grade 3… I am 59 years old. I try once the pessary and not went well.. the doctor said direct to surgery(hysterectomy) .. I don’t like the idea so much.. it is any other actions that I should do? Regards, CN

    • Michelle Kenway Physiotherapist says:

      Hi Charo

      Yes this is when it becomes tricky. The options are pelvic floor exercises and/or trialling different pessaries. It can take some trial and error to get a well fitting pessary that suits. Unfortunately these are the options.


  8. Hi, thank you for all of the information…

    I have a moderately severe prolapse and am waiting for surgery. I have had two back to back vaginal births and have been weight training throughout pregnancy and 6 weeks after with Dr’s ok, having no idea or information that all the push ups, planks, chin ups and heavy weights could potentially cause this issue when my pelvic tissues were already stretched and weakened… very frustrating as I had advised my Dr of the cramping of muscles and discomfort through my pregnancies and was still okayed to continue with my strenuous workout routine.

    Anyways, I’m a police officer and need strength for my line of work, so I appreciate the suggestions for modified exercises as opposed to other websites less then helpful suggestions of just not doing any form of strength training… My concern is that I wear a heavy gun belt and when I’m sitting for 12 hour shifts in my car or at a computer with it on it pushes down and into my bladder and since I’ve been back to work after my maternity for a few weeks my discomfort and symptoms having been getting worse. I really want to keep being a front line officer while I’m waiting for surgery, but I am concerned that my belt may make things worse. Also if things are getting worse, are there any complications that can occur while I’m waiting several months for my surgery? I’m concerned about doing other damage or getting an infection? Thank you for your time!

    • Michelle Kenway Physiotherapist says:

      Hi Jennifer

      Thanks for your comment/question. Has your gynaecologist/obstetrician discussed support pessary with you to help you perform your regular duties? This along with pelvic floor exercises are both feasible to include in your current management plan. Are you able to loosen your belt sitting at your computer to reduce the pressure downwards on your pelvic floor when sitting? If the belt is tight it will increase pressure downwards on your pelvic floor. Finally the risk of vaginal infection is unlikely – this is not usually a problem associated with prolapse. I can’t say whether the prolapse will worsen while you wait for surgery and I don’t think anyone could accurately answer this, it depends on your activities, pelvic floor strength, body weight and more.

      All the best for your surgery Jennifer, I hope this helps a little

  9. Is there much of a difference with a uterin prolapse if the uterus is inverted?

    • Michelle Kenway Physiotherapist says:

      Hi Cindy

      Women with retroverted uterus are more likely to have prolapse problems than normal positioned uterus. When the uterus is retroverted it sits more directly above the vagina making the uterus more likely to descend and prolapse within the vagina.


  10. My uterus just prolapsed a week ago, I’m in my 40’s and don’t want to think about this for the rest of my life. If I choose surgery, does my cervix need to be removed?

    • Michelle Kenway Physiotherapist says:

      Hi Bev
      No your cervix does not necessarily need to be removed if you choose to go with the surgical option. You will unfortunately need to think about this for the rest of your life because prolapse surgery does increase the risk of repeat prolapse. The best way forward is to understand your options for both conservative management and surgical intervention so that you can make a really well informed decision. It’s important to know that the younger you are when you undergo surgery the greater the risk long-term as surgical repair needs to last longer. It will be worthwhile seeing a pelvic floor physiotherapist for long-term management advice so that you know how to protect a pelvic floor and have a strengthened most effectively regardless of whether you have surgery in the future.
      All the best

  11. Virginia says:

    I had a hysterectomy 3 years ago he left my cervix and took my ovaries now I have a prolapse stage 3 the cervix is falling with vagina will excercise help or hurt

    • Michelle Kenway Physiotherapist says:

      Hi Virginia
      It really depends on what type of exercise you choose. Pelvic floor exercises will Kegel exercises are important and if done correctly should not cause any problems. Pelvic floor friendly general exercises such as those described throughout this site are the best type of exercises to perform. It may be worth discussing the possibility of support pessary with your specialist to help you exercise too.

  12. Hi Michelle,
    I am 48 years old and 25 kilos overweight, I am generally healthy and don’t take any medication, I eat healthily, plenty of fresh fruit and veg, wholegrain bread etc. (although portion control and chocolate has been an issue, clearly!) I had two children 15 months apart, weighing 10lb and 9.5lb, the first with episiotomy and forceps, 19 and 17 years ago. I have been overweight ever since. Recently I have been diagnosed with a stage 3 rectal prolapse and a stage 0-1 bladder prolapse. I generally do not suffer with constipation and following your bowel emptying techniques am able to go to the toilet without problems. I have been told I will need surgery by my gastro-enterologist, but he sent me to a urologist to see if it would be worth correcting the cystocele at the same time. After lengthy tests she was debating whether or not this would be necessary as I don’t have a serious bladder problem, and she gave me a lot of information about how my body could reject the polypropylene mesh, or that it could erode surrounding tissue and cause even worse problems. Unsurprisingly this has made me want to avoid surgery at all costs. I am working on losing the weight, I have been doing pelvic floor exercises daily and am going to get you dvd for pelvic safe regular exercise. Do you know if it is possible to manage problems like mine without surgery or is it too severe? I am just so scared and normally take responsibility for my own health where possible, I don’t even like taking a headache tablet if I can avoid it!
    Many thanks, Sam.

    • Michelle Kenway Physiotherapist says:

      Hi Sam

      Great question. I tend to agree with your urologist in that if you can avoid bladder surgery then do so. You’re doing everything right focusing on good emptying techniques, pelvic floor exercises and losing weight. Sam I’m not sure whether you’re referring to true rectal prolapse where the prolapse comes from the anus, or rectocoele (posterior vaginal wall prolapse) which bulges from the vagina as both are often confused. True rectal prolapse often requires surgical intervention when it worsens. In contrast some women find they can manage mild-to-moderate rectocoele quite well without surgery with good conservative therapy. Just a small suggestion on not overloading on too much insoluble fibre which can actually increase constipation. At the end of the day the decision for surgery is yours and it really comes down to how problematic your prolapse is unless it is a severe rectal prolapse in which case surgery is indicated.

      I hope this helps you out!
      All the best

  13. Hi Michelle, its really great that you’ve taken the time to answer everyones questions. I have one of my own. Ive recently been diagnosed with 2nd degree cystocele and 1st degree uterine prolapse, my doctor has prescribed physio for my pelvic floor, however I’m in the process of moving to a different continent with a three year old and a 4 month old… In my search for ways to isolate my muscles and be sure I am using the correct ones, I found a new device called an Elvie, perhaps you cannot comment on particular devices, but in general, are pelvic toning devices possible for someone with a cystocele? or does the device then sit improperly in the body?? any help? Thank you!

    • Michelle Kenway Physiotherapist says:

      Hi Janine
      Pelvic toning devices can be used by most women with mild-moderate prolapse it’s important to sit the device in the correct position. These devices are used lying down passively – it’s then important to start active pelvic floor contractions too with the device and then without.
      All the best