Conservative and Nonsurgical Management of Pelvic Organ Prolapse

Pelvic organ prolapse is a common condition for which treatment should be guided by symptom burden, functional impairment, and patient goals. Conservative management represents first-line therapy and includes expectant management, lifestyle and behavioral modification, pelvic floor physiotherapy, and vaginal pessary treatment. This review summarizes contemporary evidence supporting these approaches, including pelvic floor muscle training, constipation and activity management, and pessary fitting, maintenance, and outcomes. We additionally highlight recent advances in pelvic floor rehabilitation, pessary biomechanics, patient self-management, and patient-specific pessary technologies that may further individualize prolapse care.