Spire Portsmouth Gynaecology at Spire Portsmouth Hospital provides women who have bladder problems, including prolapse and incontinence, fast access to our specialist Consultant Gynaecologists. Our Gynaecologists are able to assess, diagnose and treat continence problems. Giving women back the quality of life they deserve.

Find out more about the conditions treated at Spire Portsmouth Gynaecology below.


Urinary incontinence occurs when urine is passed unintentionally. There are two main causes for this problem; stress incontinence, when there the pelvic floor muscles are too weak to prevent urination, causing leakages when the bladder is under pressure, such as during coughing or laughing; or urge incontinence when urine is passed as there is a sudden urge to urinate.

Find out more about incontinence

Incontinence has many possible causes which can include prolapse, child bearing, increasing age, being overweight or even a chronic cough.

To diagnose urinary incontinence a pelvic examination is undertaken to determine the source of the problem and then treatment is decided accordingly.

Treatments for urinary incontinence vary depending on the cause and severity of the issue however in less extreme examples physiotherapy can be undertaken to strengthen the pelvic floor muscles, lifestyle changes may also be advised such as losing weight, stopping smoking or becoming more active.

There are also long and short term options for treatment of incontinence including surgery which would be discussed in the consultation.


Prolapse means that there is a muscle out of its normal position. With pelvic organ prolapse this affects organs such as the womb, rectum or bladder. When one of the muscles or ligaments holding one of these organs is weakened or damaged the organs can fall out of position causing prolapse.

Find out more about prolapse

Pelvic organ prolapse can cause a variety of different symptoms:

  • a feeling of something coming out of the vagina
  • feeling full
  • difficulty having sex
  • leaking urine during coughing, sneezing or laughing (stress incontinence)

There are several different types of pelvic organ prolapse depending on which organ is being pushed into the vagina:

  • uterine prolapse - the womb pushing into the vagina
  • vaginal vault prolapse - the top of the vagina falling into the vagina (usually after womb removal from a hysterectomy)
  • enterocele - the small bowel pushing into the vagina
  • rectocele - the rectum pushing into the vagina
  • cystocele - the bladder pushing into the vagina

Prolapse occurs most commonly in women who have given birth or have been through the menopause1.

The most common treatments for prolapse include pelvic floor exercises and lifestyle changes in mild cases of prolapse. In more severe cases of prolapse a device may be implanted to support the prolapsed organ, known as a vaginal pessary. In the most severe cases of uterine prolapse a hysterectomy may be performed to remove the womb. All of the options will be discussed in detail.

Women's health physiotherapy

At Spire Portsmouth Hospital, we have a specialist physiotherapist whose particular interest is female pelvic floor rehabilitation for treating continence problems including urinary incontinence.

Melanie de Lacy, MCSP has many years of experience in working in women's health physiotherapy and can help to provide further options for women who are unsuitable for surgery or would prefer not to have surgery. 

Find out more about women's health physiotherapy

Women's health physiotherapy can be aimed at many female issues however it is most commonly used to help those suffering with continence issues.

Most often continence issues can stem from child birth, being overweight or the menopause. These can all put strain on the body which can weaken some muscles, causing prolapse. Pelvic floor rehabilitation is designed to strengthen the weakened muscles to prevent further problems and help make symptoms more manageable.

The exercises are given in one on one classes with Melanie de Lacy, our specialist physiotherapist, who can put together a plan of exercises to help manage the symptoms.