Concierge pelvic health · UK
Pelvic floor disorders - treated properly, in the right order.
Leaking, urgency, prolapse, bowel symptoms, pelvic pain - common, life-limiting and highly treatable. One pathway from specialist physiotherapy through pessaries and injections to mesh-free surgery, staged the way the evidence says.
Why patients choose us
- 01
A whole pathway, not a single specialist
Pelvic floor problems sit between urogynaecology, colorectal surgery, urology and physiotherapy. We assemble the right combination for your symptoms - not whichever clinic answered first.
- 02
Conservative first, surgery when earned
UK guidance is clear: supervised physiotherapy and pessaries before any operation for most prolapse and incontinence. Our pathway is built in that order, honestly.
- 03
Independent, and free
We are paid by no clinic, so the recommendation - physio, pessary, or theatre - is impartial and costs you nothing.
Indicative pricing
What private pelvic floor treatment costs in the UK.
Most patients spend at the conservative end of this table. Send the details and we quote firm figures for your pathway, with cover checked.
In short
Assessment plus a physiotherapy course: £670–£1,230. Surgery, if ever needed: £5,500–£9,500.
| Treatment | Indicative range | Typical duration | Setting |
|---|---|---|---|
| Specialist assessment (urogynaecology or colorectal) | £250–£450 | 45–60 min | Plan same visit |
| Pelvic floor physiotherapy course (6 sessions) | £420–£780 | 45–60 min each | Weekly to fortnightly |
| Pessary fitting and review | £150–£350 | 20–30 min | Fitted same visit |
| Urodynamic studies | £800–£1,500 | 60–90 min | Report in days |
| Bladder Botox for overactive bladder | £2,000–£3,500 | 20–30 min | Day-case |
| Urethral bulking injections | £3,000–£5,000 | 20–30 min | Day-case |
| Prolapse repair surgery | £5,500–£9,500 | 60–120 min | 1–2 nights |
All of this exists on the NHS, and for many patients that is the right route - the barrier is usually waiting time for physiotherapy and urogynaecology clinics. Private care buys speed and continuity; the clinical staging is identical. We quote firm figures within one working day.
The problem
Endured for years, mentioned to no one, treated piecemeal.
The average woman waits years before seeking help for incontinence - and then bounces between clinics that each see one third of the problem. We fix the pathway, not just the symptom.
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Common is not normal
One in three women leaks; that makes it common, not something to live with. Nearly all pelvic floor symptoms improve with proper treatment.
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Assess all three compartments
Bladder, vagina, bowel - symptoms cluster. An assessment that only asks about one will miss what actually bothers you most.
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Stage the treatment, and measure it
Physio before pessary before theatre - with symptom scores repeated at each stage so escalation is a decision, not a drift.
The journey
From enquiry to lasting control - what happens, in order.
One team from first message through assessment, the conservative programme, any procedures, and the long-term reviews.
Phase 1 · Assessment & plan
Examination, tests, staged plan
Phase 2 · Treatment
Physio, pessary, or procedure
Phase 3 · After
Re-scoring, maintenance
- 01
Assessment
You tell us what is going on
A short, confidential form. Leaking, urgency, a bulge or dragging, bowel symptoms, pain - plus births, surgery and what you have already tried.
- 02
Assessment
We come back with a recommendation
Within one working day: the right starting specialist - urogynaecologist, colorectal surgeon or pelvic health physiotherapist - and an indicative price for the assessment.
- 03
Assessment
Proper assessment
Examination with prolapse grading, bladder diary, and tests where needed - urodynamics for complex incontinence, ultrasound, or anorectal studies for bowel symptoms.
- 04
Assessment
A staged plan you agree to
Almost always conservative first: a supervised pelvic floor physiotherapy programme, pessary fitting where it helps, bladder or bowel retraining, and lifestyle changes that actually move the needle.
- 05
Treatment
Treatment, at the right intensity
For most, treatment means physiotherapy appointments and reviews. Where a procedure is chosen - pessary change, Botox for the overactive bladder, bulking injections or prolapse repair - it happens in the right clinic or theatre.
- 06
Treatment
Same-day procedures, short stays
Bladder Botox and urethral bulking are day-case under local or light sedation. Prolapse and continence surgery usually means one night, occasionally two.
- 07
After
Review, and the long game
Symptom scores repeated at 3 months to prove progress. Physiotherapy maintenance, pessary reviews every 6 months, or post-surgical follow-up - the pelvic floor is managed over years, not visits.
Typical conservative programme: 3–4 months. Formal re-scoring: at 3 months, before any escalation.
When it helps
The symptoms this pathway is built for.
The situations we see most, plus the red flags that need same-day care rather than any pathway.
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Stress incontinence
Leaking with coughs, sneezes, laughter or exercise - the commonest pelvic floor problem, and one of the most treatable.
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Urgency and overactive bladder
Sudden desperate urges, frequent trips, waking at night - a bladder-retraining and medication pathway, with Botox for resistant cases.
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Pelvic organ prolapse
A bulge, heaviness or dragging from the bladder, womb or bowel descending - graded on examination, managed from pessary to repair.
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Bowel symptoms: leakage or obstructed emptying
Faecal urgency, leakage or a sensation of incomplete emptying - the colorectal side of the pelvic floor, often missed in gynaecology-only clinics.
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Symptoms after childbirth
Leaking or heaviness months after delivery, or a known significant tear - postnatal pelvic floor problems respond best treated early.
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Pelvic pain and hypertonic floor
An overtight, painful pelvic floor causing pain, urinary hesitancy or painful sex - needs down-training, not strengthening.
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Symptoms around menopause
Falling oestrogen thins pelvic tissues and unmasks weakness - vaginal oestrogen plus physiotherapy is a powerful, underused combination.
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Red flag: retention, blood or numbness
Inability to pass urine, blood in urine or stool, or new numbness in the saddle area needs urgent same-day assessment - not a routine booking.
Treatment options
A ladder of options - most people never need the top rungs.
What each option involves, from the physiotherapy foundation everything rests on to the operations reserved for symptoms that persist despite it.
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Supervised pelvic floor physiotherapy
The evidence-based foundation for prolapse and incontinence - at least 16 weeks of supervised training before surgery is considered, per NICE.
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Vaginal pessaries
A silicone support fitted in clinic that holds prolapse comfortably - a definitive long-term choice for many, not merely a stopgap for the elderly.
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Bladder retraining and medication
Scheduled voiding plus anticholinergic or beta-3 medication for overactive bladder - reviewed properly, because side-effects are the usual reason it fails.
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Vaginal oestrogen
Low-dose local oestrogen restores tissue quality around menopause - safe for most women, including many after breast cancer, with specialist advice.
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Bladder Botox
Injections into the bladder wall calm resistant overactive bladder for 6–12 months at a time. Day-case, repeatable, with a small self-catheterisation risk explained honestly.
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Urethral bulking
Injectable gel narrows the leaking urethra - a low-risk day-case option for stress incontinence, less durable than surgery but easily repeated.
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Continence and prolapse surgery
Native-tissue prolapse repair, colposuspension and fascial slings - mesh-free options are the UK standard, discussed with full data on success and re-operation.
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Sacral neuromodulation and bowel therapies
A pacemaker-like stimulator for resistant bladder or bowel symptoms, plus irrigation and biofeedback for evacuation disorders - via specialist pelvic floor MDTs.
Our vetted UK network
A pelvic floor team, assembled around you.
Urogynaecologists, colorectal surgeons and specialist physiotherapists across London and the major UK cities. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinician in our network.
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Urogynaecologists and colorectal surgeons who work in genuine pelvic floor MDTs
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Specialist pelvic health physiotherapists embedded in the same pathway
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Mesh-free surgical practice in line with current UK guidance, with outcomes shared openly
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Urodynamics and anorectal physiology on site, used selectively rather than routinely
Safety and expectations
What to expect from each rung - honestly.
The conservative options are close to risk-free; procedures carry real trade-offs that deserve numbers, not reassurance. Here they are.
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Conservative care is genuinely effective
Supervised physiotherapy cures or substantially improves stress incontinence in the majority who complete it, and improves early prolapse symptoms - which is why it comes first, not because it is cheap.
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Pessaries: comfortable when fitted well
A correctly sized pessary should be unfelt. Discharge or discomfort means the fit needs adjusting; reviews every six months keep tissues healthy.
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Medication side-effects
Bladder drugs commonly cause dry mouth, constipation or, in older patients, cognitive effects. A drug that makes life worse should be changed, not endured.
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Botox and the catheter question
After bladder Botox, roughly 5–10 percent of patients temporarily need to self-catheterise. Anyone considering it is taught the technique first - informed consent means knowing this beforehand.
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Surgery: success and recurrence
Prolapse repair improves symptoms in most, but roughly one woman in four needs further treatment over her lifetime. Honest counselling includes that number.
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The mesh legacy
Vaginal mesh for prolapse is no longer used in the UK, and mesh slings remain under national restriction. Every surgical option we arrange is native-tissue unless an MDT documents an exception.
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Surgical risks in brief
Bleeding, infection, bladder or bowel injury and new bladder symptoms each affect a small percentage of operations. Anaesthetic review and DVT prevention are standard.
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Life factors move the needle
Weight, chronic cough, constipation and heavy lifting all load the pelvic floor. Addressing them is treatment, not lifestyle advice appended to it.
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Red flags during treatment
Inability to pass urine, fever after a procedure, heavy bleeding, or new saddle numbness need the same-day team or A&E - never the next routine review.
Reading your assessment letter
Your assessment letter in four parts. Read the last one first.
Whether your assessment was with a surgeon or a physiotherapist, the letter you receive keeps to the same shape.
A quiet reminder
Grades, stages and acronyms can feel clinical about something intimate - we translate them for you.
If you would like us to talk you through your letter and options before deciding anything, just ask.
- 01 Header
Your diagnosis, precisely named
Which compartment is affected, the prolapse grade or incontinence type, and the bladder or bowel test results that define it.
- 02 Technique
What was assessed and how
The examinations performed, the diary and questionnaire scores, and any urodynamic or anorectal findings - the baseline your progress is measured against.
- 03 Findings
What the tests actually showed
Plain-language versions of the pressure traces, grades and measurements - including the reassurances, which matter as much as the findings.
- 04 Impression
The staged plan
Read this first: what starts now, what is held in reserve, when success will be measured, and the trigger points for stepping up to a procedure.
Recognised by major UK insurers
Specialist assessment, physiotherapy and surgery for pelvic floor disorders are usually covered when medically indicated. We confirm cover before booking.
Frequently asked
Everything we get asked about pelvic floor treatment.
Quick answers on what counts, surgery, mesh, men’s pelvic health, cost and timescales.
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What counts as a pelvic floor disorder?
An umbrella covering everything that goes wrong when the muscular floor of the pelvis weakens, overtightens or is damaged: stress and urgency urinary incontinence, pelvic organ prolapse, faecal incontinence and evacuation difficulty, and pelvic floor muscle pain. They frequently coexist - around a third of women with one have another - which is why assessment across bladder, bowel and support matters more than a single-symptom referral.
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Do I have to have surgery?
Usually not, and never first. UK guidance places supervised pelvic floor physiotherapy - a proper programme of at least three to four months - before surgery for stress incontinence and early prolapse, with pessaries as a durable non-surgical option for prolapse at any age. Surgery earns its place when conservative care has genuinely been tried and symptoms still intrude on life. Many of our patients never see a theatre.
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Is this just a women’s issue?
No. Pelvic floor disorders are far commoner in women - childbirth and menopause are the big drivers - but men experience urinary incontinence after prostate surgery, chronic pelvic pain and bowel dysfunction too, and pelvic health physiotherapy is just as effective for them. Our network includes clinicians who treat men, and we route accordingly.
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What happened with vaginal mesh - is it still used?
Following the Cumberlege review, vaginal mesh for prolapse is no longer used in the UK, and mesh mid-urethral slings remain effectively paused except in exceptional, high-vigilance circumstances. Current UK practice uses native-tissue repairs, colposuspension and fascial slings instead. Every surgeon we introduce operates mesh-free in line with that guidance, and will explain the evidence for the alternatives openly.
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What does private treatment cost in the UK?
Assessment with a specialist runs £250–£450. A six-session physiotherapy course is typically £420–£780, pessary fitting £150–£350, and urodynamics £800–£1,500 when needed. Procedures range from £2,000–£3,500 for bladder Botox and £3,000–£5,000 for bulking injections up to £5,500–£9,500 for prolapse repair. We quote a firm figure for your specific pathway within one working day.
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How long before I notice improvement?
Physiotherapy typically shows meaningful improvement by 8–12 weeks, with maximum benefit at four to six months of consistent practice. A pessary works the day it is fitted. Bladder medication and retraining take four to six weeks to judge fairly, Botox works within two weeks and lasts six to twelve months, and surgical results are assessed at the three-month review. Whichever route, we re-score your symptoms formally so progress is measured rather than guessed.
Related treatments
Looking for something else?
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Pelvic floor physiotherapy
The foundation of this pathway, in detail.
Learn more -
Pelvic floor repair
The surgical option for prolapse.
Learn more -
Pelvic exam
The assessment that starts everything.
Learn more -
Menopause - condition guide
Hormones and the pelvic floor.
Learn more -
Hysterectomy
Sometimes combined with prolapse surgery.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more