Postnatal POP Service
Research type
Research Study
Full title
A Physiotherapy-Led Service for Postnatal Women with Vaginal Prolapse
IRAS ID
354513
Contact name
Claire Brown
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundation Trust
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Vaginal prolapse is a bulge or a feeling of heaviness in the vagina. It happens when one or more of the organs (bladder, bowel or womb) in the pelvis move down from their normal position into the vagina. Childbirth is one of the largest risk factors of developing a prolapse, with 43% of women report severe symptoms at one year after childbirth. A prolapse can stop women doing normal activities such as lifting the baby or pushing the pram because it can make symptoms worse.
Treatment of prolapse includes pelvic floor muscle exercises, a pessary or surgery. Surgery can cause long term complications and repeat surgery rates are high. A pessary is a device put inside the vagina to hold up the prolapse. A pessary can stop symptoms immediately. There are however problems for postnatal women accessing care for prolapse:
These problems are:
1) Poorly designed care pathways can result in multiple trips to the doctor before being referred for pelvic floor muscle exercise instruction, and again for a pessary.
2) Postnatal women with prolapse are not always offered a pessary. Interviews with women and clinicians and a recent survey, showed 82% of GPs will not offer a pessary.
A potential solution is having a service designed by and for women with prolapse could provide more treatment options and allow women to make better-informed choices. This will be done by asking treating clinicians to complete a questionnaire to understand the problems with postnatal referral routes and locations of clinics. Clinicians will be then be interviewed, to help us understand why current pathways exist.
A new service will then be designed by women with prolapse and by experienced clinicians. Information gathered from step one will highlight areas for improvement or decisions that will need to be made.
REC name
London - London Bridge Research Ethics Committee
REC reference
25/PR/1299
Date of REC Opinion
26 Sep 2025
REC opinion
Favourable Opinion