@mslw and @sulli
I had a prolapsed bladder for about 10 years. It finally reached stage 4 despite the fact that I tried many of the pelvic floor exercises but was not able to get it to stabilize. I finally had surgery but that was with the third urogynecologist that I went to. Certainly at stage 1 or 2 an exercise or pt approach may work better than it did on my stage 3-4. I consulted a website called Whole Woman (www.wholewoman.com) during my attempt to find an alternative to surgery. The founder is a woman named Christine Kent and she explores a number of therapies. She is a true believer in pelvic floor therapy. I read some of her literature and tried her approach. I also know that many people will try to scare you out of surgery so be mindful of that was well. I believe in getting as many opinions as you can from reputable urogynecologists and other options such as physical therapies. I found that my regular gynecologist was a little more conservative and had more interest in helping me with other therapies besides surgery than did the urogynecologists that I consulted. Most of them were more surgery-oriented. If you are located in an area where there is a medical school or where there are more new age type of folks, you might be more successful in trying to find alternatives. I first visited a urogynecologist who was very pushy and like you say, I was not interested in being pushed. After several years, I tried a pessary at a gynecologist who had a nurse who basically did nothing but fit pessaries. There are many different kinds so if you can find someone who does a lot of pessary fittings and has the patience to help you while you try to find one that works best, then this might be an option for you. I recall the relief when I first tried a pessary as all of the sudden that "bulge" was gone.

One thing that did start to happen is I had a little incontinence after having the pessary for a while. This is because the prolapse can mask incontinence by dropping so far down that the gravity/physics of the situation inhibits the flow of urine. Once the bladder is lifted by the pessary, this inhibition is no longer there. There is literature suggesting that the success of the pessary, even short term, depends on the stage of prolapse. After a while it just got to the point where it would not stay in place but my prolapse was stage 4 by then. I do feel that the time I put the surgery off was valuable in that by the time I did it I had gotten a number of opinions, tried many things, and was thus very comfortable with surgery. The surgery was also a very non-invasive one compared to what I might have had ten years prior.

I would try looking at the Whole Woman site and other literature she sites and try some of her approaches. Also, keep the pessary in mind. I have not searched for these approaches in a number of years since I ultimately did have surgery two years ago, but I believe in trying all that you can before surgery so that if you do end up with a surgery you have done your homework and are completely comfortable with your decision. It becomes a quality of life issue in my opinion. If it is not causing you pain or too much inconvenience or interfering with your life then I would say you should be looking into alternative therapies..

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