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 NICE NG210.
For stress urinary incontinence or mixed urinary incontinence, a supervised pelvic floor muscle training programme for at least 3 months is recommended NICE NG210.
Women with faecal incontinence and coexisting pelvic organ prolapse may also benefit from supervised pelvic floor muscle training for at least 4 months NICE NG210.
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 NICE NG210.
Intravaginal devices for urinary incontinence can be considered if other non-surgical options have been unsuccessful NICE NG210.
Pessaries are an option for women with symptomatic pelvic organ prolapse, either alone or with pelvic floor muscle training NICE NG210.
Lifestyle modifications such as losing weight if BMI is over 30 kg/m2, minimizing heavy lifting, and preventing or treating constipation are also advised NICE NG210.
Vaginal oestrogen may be considered for women with pelvic organ prolapse and menopausal genitourinary symptoms NICE NG210.
Group or individual supervised pelvic floor muscle training sessions are options, with reviews to assess progress NICE NG210.