What is the cost of pelvic organ prolapse to the NHS?

Pelvic organ prolapse affects 1 in 3 women and a small percentage of men but many aren’t aware of the symptoms or causes. To find out the true cost of pelvic organ prolapse, pelvic healthcare company Kegel8 has analysed exclusive data* to reveal which areas in England are the most affected and how it impacts NHS Trusts financially.

According to the NHS, pelvic organ prolapse is when one or more of the organs in the pelvis – e.g. the uterus, bowel, bladder, rectum or top of the vagina – slips down from its normal position.

Although not life threatening, prolapse can have a significant impact on a person’s physical, psychological and social wellbeing, ultimately reducing their quality of life. Symptoms can include a feeling of heaviness around the lower stomach and pelvic area, a loss of intimate sensation or performance, pain and discomfort, and problems urinating.

So, how much does pelvic organ prolapse cost the NHS annually?

The most recent data reveals over £45 million was spent by the NHS on treatments between 2017 and 2018. A staggering 25 percent of this spend was in the South West alone (£12,665,050.90), with NHS Trusts in London (£7,675,072.94) and the South East (£8,991,321) also spending vast sums treating pelvic organ prolapse

NHS Trusts in the North East (£347,440), East Midlands (£1,331,491) and East of England (£2,013,371.17) had the lowest spend compared to other regions.

Pelvic organ prolapse is caused by a weakness in the pelvic floor muscles which support the pelvic organs. Several things can affect the strength of your pelvic floor, including:

• Pregnancy and childbirth
• Ageing and the menopause
• Being overweight or obese
• Undergoing a hysterectomy

In fact, hysterectomies are the leading cause of pelvic organ prolapse in women due to the removal of the uterus compromising structural support at the top of the vagina. However, 1 in 3 women will end up prolapsing again as the other pelvic organs lose support, creating a vicious cycle.

Of those studied, NHS Trusts in England performed over 23,000 hysterectomies between 2017 and 2018 alone. The most common reason cited for a hysterectomy was uterine fibroids (non-cancerous growths in the uterus), followed by endometrial cancer, irregular menstrual bleeding and uterovaginal prolapse.

Pelvic organ prolapse will usually be classified on a scale of 1 to 4 to show how severe it is, with 4 being a severe prolapse which requires surgical intervention.

According to NICE guidelines, pelvic floor muscle training should be the first treatment option for women with stage 1 or 2 pelvic organ prolapse. However, despite the value of pelvic floor training for both prevention and treatment, Kegel8 can reveal only 16 NHS Trusts in England studied offer this.

Coupled with the findings of a recent study that women in particular miss out on early treatment due to a lack of awareness or feeling too embarrassed to speak to a GP, catching a pelvic prolapse before it becomes stage 3 or 4 is rarer than it should be.

Stephanie Taylor, Managing Director of Kegel8, commented:

“This study highlights the need for greater awareness and education about pelvic health and treatment options, both among the general population and healthcare professionals. For too long, both women and men have been kept in the dark about pelvic floor issues which can be devastating to quality of life and intimacy. It is also costing the NHS huge amounts of money to put right.

 “Just like brushing your teeth, looking after your pelvic floor should be an important part of your daily routine. By practicing Kegel exercises, either manually or with the help of an electric toner, both women and men can strengthen and build muscle tone in just a few weeks, helping to prevent prolapse.”