Watch and Wait for Prolapse
For many women with pelvic organ prolapse, especially in mild cases, you may not need treatment right away. “Watch and wait,” or watchful waiting, is a valid way to manage it. Left alone, most prolapse stays about the same: in one study, 78% of women with symptomatic, untreated prolapse had no change at 16 months, and mild prolapse sometimes improves on its own.
What is Watch and Wait?
You and your doctor keep track of your prolapse over time without treating it right away. This is often recommended when:
- Your prolapse is mild
- You have minimal or no symptoms
- Your quality of life is not significantly affected
Who is a Good Candidate?
You might be a good candidate for watchful waiting if:
- Your prolapse doesn’t extend beyond the opening of your vagina
- You’re not experiencing discomfort or pain
- The prolapse doesn’t interfere with your daily activities or sexual function
- You prefer to avoid treatment for now
Benefits of Watchful Waiting
- Avoids unnecessary treatment
- Gives you time to see if symptoms progress or resolve on their own
- Gives you a chance to try conservative measures like pelvic floor exercises
- Spares you the risks of more invasive treatments
What to Expect
During the watchful waiting period:
- You’ll tell your doctor about any new or worsening symptoms
- You may learn pelvic floor exercises to help support your pelvic organs
- Your doctor may recommend lifestyle changes to keep the prolapse from getting worse
Self-Care During Watchful Waiting
Things you can do yourself in the meantime:
- Practice pelvic floor exercises regularly
- Maintain a healthy weight
- Use good body mechanics when lifting
- Treat chronic cough or constipation
- Stay physically active
When to Consider Other Treatments
It may be time to look at other treatments if:
- Your symptoms worsen
- The prolapse progresses
- You start experiencing pain or discomfort
- You have trouble emptying your bladder or bowel
- Your quality of life suffers
Making the Decision
Whether to watch and wait is your call, made together with your doctor. Good questions to ask:
- What signs should I watch for?
- How often should I have check-ups?
- What can I do to prevent the prolapse from worsening?
Watchful waiting still means paying attention to changes, so you can move to treatment if and when you need it.
References
- Carberry CL, Tulikangas PK, Ridgeway BM, et al. American Urogynecologic Society Best Practice Statement: Evaluation and Counseling of Patients With Pelvic Organ Prolapse. Urogynecology. 2025. doi:10.1097/SPV.0000000000001641
- Committee on Practice Bulletins—Gynecology, American Urogynecologic Society. Pelvic Organ Prolapse (ACOG Practice Bulletin No. 214). Obstetrics & Gynecology. 2019.
- Barber MD. Pelvic organ prolapse. BMJ. 2016. doi:10.1136/bmj.i3853
- Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. The Lancet. 2014. doi:10.1016/S0140-6736(13)61977-7
- Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics and Gynecology. 2019. doi:10.1097/GCO.0000000000000584