What non-surgical management options are available for women with pelvic floor disorders?

Non-surgical management options for women with pelvic floor disorders include a programme of supervised pelvic floor muscle training for at least 4 months for pelvic organ prolapse that does not extend greater than 1 cm beyond the hymen upon straining ¹.

For stress urinary incontinence or mixed urinary incontinence, a supervised pelvic floor muscle training programme for at least 3 months is recommended ¹.

Women with faecal incontinence and coexisting pelvic organ prolapse may also benefit from supervised pelvic floor muscle training for at least 4 months ¹.

Women who are unable to perform effective pelvic floor muscle contractions may be considered for supplementing training with biofeedback techniques, electrical stimulation, or vaginal cones ¹.

Intravaginal devices for urinary incontinence can be considered if other non-surgical options have been unsuccessful ¹.

Pessaries are an option for women with symptomatic pelvic organ prolapse, either alone or with pelvic floor muscle training ¹.

Lifestyle modifications such as losing weight if BMI is over 30 kg/m2, minimizing heavy lifting, and preventing or treating constipation are also advised ¹.

Vaginal oestrogen may be considered for women with pelvic organ prolapse and menopausal genitourinary symptoms ¹.

Group or individual supervised pelvic floor muscle training sessions are options, with reviews to assess progress ¹.