What is the Bladder?
The bladder is a hollow, balloon-like organ made mostly of muscle. It stores urine before it leaves the body through the urethra.
What is Bladder Prolapse?
Also called cystocele; in severe cases, the prolapsed bladder can appear at the opening of the vagina. Sometimes it can even protrude (drop) through the vaginal opening. Bladder prolapse is common in women. The symptoms of bladder prolapse can be pain or discomfort in the vagina, pelvis, lower abdomen, groin, and lower back. Bladder prolapse means you may have frequent urination or the urge to urinate, or you 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. If you are one of them, you may have a heaviness or pressure in the vaginal area; painful intercourse; or 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.
What is Pelvic Organ Bladder Prolapse?
Under normal conditions in women, the pelvic organs are held in place by a "hammock" of supportive pelvic floor muscles and connective tissue. When these tissues are stretched and/or become weak, the bladder, small bowel, rectum, vagina, and urethra can drop and bulge through this layer into the vagina.
Causes of pelvic organ prolapse are pregnancy and childbirth, aging and menopause, obesity, fibroids, chronic coughing or constipation, lifting heavy objects, prior pelvic surgery, certain genetic conditions, and some neurological conditions or spinal cord injury. These prolapses can be treated as non-surgical treatments and surgical approaches.
Types of Pelvic Organ Prolapse
There are different types of pelvic organ prolapse which include:
- Cystocele (Anterior Prolapse)
- Rectocele (Posterior Prolapse)
- Uterine Prolapse
- Vaginal Vault Prolapse
- Enterocele
- Apical Prolapse
What is Small Bowel Prolapse?
Also called enterocele is when the small intestine drops down between the back of the vagina and the rectum. This may occur at the same time as the prolapse of the uterus or rectum.
What is Rectum Prolapse?
A rectocele is present when the rectum bulges into the back of the vagina.
What is Uterus Prolapse?
Uterine prolapse occurs when the uterus drops down in the vagina.
What is Urethra Prolapse?
A Urethrocele develops when the urethra, which transports urine from the bladder and out of the body, slips, and pushes against the lower part of the front of the vagina.
What is a Vaginal Vault Prolapse?
This can only occur if the woman has had a hysterectomy. It is when the top of the vagina falls in on itself.
What causes Bladder Prolapse?
Bladder prolapse can develop for many reasons. The most important factor is stress on this supportive “hammock” of muscles during vaginal 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.
Symptoms
Bladder prolapse means you may have frequent urination or the urge to urinate, or you 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:
- vagina
- pelvis
- lower abdomen
- groin
- lower back
If you are one of them, you may have a heaviness or pressure in the vaginal area; painful intercourse; or 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 it diagnosed?
Prolapse can usually be detected with a pelvic exam.
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.
Bladder Prolapse Treatments
For mild prolapse cases, you can learn “Kegel” exercises and other pelvic floor exercises to make the pelvic floor muscles stronger and possibly help treat prolapse. Other Bladder Prolapse treatments for more advanced cases can include estrogen replacement therapy. A pessary, which is a vaginal wall support device, can provide better support for your internal organs, including the bladder.
You may need surgery for bladder prolapse treatments 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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