Bladder prolapse affects only women. Under normal conditions, the bladder is held in position by a “hammock” of supporting pelvic floor muscles and ligaments. If these muscles and tissues stretch or become weak the bladder can sag into the vagina*. This is known as bladder prolapse or a cystocele.
In some women, the sagging bladder will appear at the vagina’s opening and can even drop through it. Bladder prolapse can be very bothersome. It can cause problems when emptying the bladder and urinary tract infections (UTIs) or incontinence (urine leakage). The good news is, bladder prolapse can usually be corrected.
What Causes Bladder Prolapse?
Bladder prolapse can develop for many reasons. The most important factor is stress on this supportive “hammock” of muscles during childbirth. If you had many pregnancies or have delivered vaginally you are at higher risk for bladder prolapse.
Heavy lifting or chronic coughing can lead to prolapse in some women. Even constipation or frequently straining to pass stool, obesity or being overweight, menopause (when estrogen levels start to drop) and pelvic surgery may contribute to bladder prolapse.
What Are the Symptoms for Bladder Prolapse?
Bladder prolapse means you may have:
- frequent urination or the urge to urinate
- may leak urine with activity, known as stress urinary incontinence
You may not feel bladder relief immediately after urinating. You may have frequent urinary tract infections. Some women have discomfort or pain in the:
- lower abdomen
- lower back.
If you are one of them, you may have a heaviness or pressure:
- in the vaginal area
- painful intercourse
- tissue that can be seen coming out of the vagina that may be tender or bleeding
If you have a mild case, it may not cause any symptoms.
How is Bladder Prolapse Diagnosed?
Prolapse can usually be detected with a pelvic examination. However, a test called a voiding cystourethrogram may be required. This test involves a series of X-ray pictures that are taken during urination. These pictures will show the shape of the bladder and will help identify obstructions blocking the normal flow of urine. Other X-rays and tests may also be required to find or rule out problems in other parts of the urinary system.
How is Bladder Prolapse Treated?
For mild prolapse cases, you can learn “Kegel” exercises to make the pelvic floor muscles stronger and possibly help treat prolapse. Other treatments for more advanced cases can include estrogen replacement therapy.
A pessary, which is a vaginal support device, can provide better support for your internal organs, including the bladder. You may need surgery if you have a bothersome case that cannot be managed with a pessary or exercise. If your prolapse is left untreated, over time the condition may get worse. In rare cases, severe prolapse can cause urinary retention, which is the inability to urinate. This may lead to kidney damage or infections. Speak to your health care provider if you are concerned about bladder prolapse.
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