Bladder Prolapse

About Prolapsed Bladder

In women, the front wall of the vagina normally holds the bladder steady. After pregnancy and childbirth as well as with advancing age, the front wall of the vagina may be weakened, which means the bladder is no longer supported by the vaginal wall and the bladder prolapses, or drops. Childbirth is the most common cause of a prolapsed bladder. The walls of a woman’s bladder help maintain support for the bladder, but childbirth can put excess strain on the walls and cause them to lose some of their strength.  In addition, menopause, as well as straining to pick up heavy objects can cause bladder prolapse.

Stress incontinence is an immediate symptom of bladder prolapse. A urologist will rate prolapsed bladders on a scale of 1 to 4, grading how far the bladder has pushed into the vagina.

The scale is as follows:

Grade 1:
  Only a very small part of the bladder has fallen into the vagina.
Grade 2:  The bladder has fallen enough to reach the opening of the vagina.
Grade 3:  The bladder sticks out of the body through the opening of the vagina (severe prolapsed bladder).
Grade 4:  The entire bladder protrudes from the vagina (complete prolapsed bladder).

Symptoms


Those who suffer from a prolapsed bladder will have discomfort or pain in the pelvis, are not able to fully empty their bladder when urinating, may have stress incontinence, painful intercourse and lower back pain. Because symptoms can worsen, it is important for patients to speak to their doctor immediately upon recognizing a problem. Prolapsed bladders do not heal without medical intervention.

Treatment Options

A doctor may use a cystourethrogram to aid with the diagnosis, as well as a urodynamic test, which is used to measure the flow of urine. For patients who are not ready to have surgical treatment, a pessary and/ or estrogen replacement therapy may be used. A pessary is a plastic device inserted into the vagina to keep the bladder in place. Some patients have reported a slight discomfort from this pessary. Estrogen replacement therapy may also benefit women with prolapsed bladders. Your doctor will also recommend that you refrain from heavy lifting and vigorous exercise.

After most bladder repair surgery including sling procedures and cystocele repair, most patients are sent home the same day as the surgery. Side effects of prolapsed bladder surgery include infection, injury to the bladder, urinary retention, urinary incontinence, and the formation of an abnormal connection between organs.  

Obesity, constipation, smoking, heavy lifting, multiple childbirths, and long periods of time spent standing can all make a bladder prolapse more likely.

Physicians emphasize that a high-fiber diet, drinking plenty of fluids, quitting smoking, weight loss, and pelvic exercises may reduce the risk of urinary incontinence and pelvic prolapsed.

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