What is Bladder Prolapse?
In women, the bladder is normally held in place by a supportive “hammock” of muscles and tissues in the pelvic area. When these muscles and tissues get stretched or weak, the bladder can drop down and push into the vagina. This is called bladder prolapse or cystocele. In serious cases, the bladder can bulge so much that it can be seen or felt at the opening of the vagina. Bladder prolapse is common in women, and while the symptoms can be uncomfortable, it can be treated.
The most common symptom is feeling or seeing a bulge in the vagina. Other symptoms may include:
Feeling like you need to urinate often or urgently.
Urinary incontinence (leaking urine).
Not feeling relief after urinating.
Frequent urinary tract infections (UTIs).
Pain in the vagina, pelvis, lower belly, groin, or lower back.
A feeling of heaviness or pressure in the vaginal area.
Painful sex.
Tissue sticking out of the vagina that might be tender or bleed.
The main cause of bladder prolapse is stress on the pelvic muscles, especially during childbirth. Women who have:
Multiple pregnancies.
Vaginal deliveries.
Long or difficult labors.
are at higher risk.
Other factors that can lead to bladder prolapse include:
Heavy lifting.
Chronic coughing (from lung problems or smoking).
Constipation or straining to pass stool.
Obesity.
Menopause (when estrogen levels drop).
Aging.
Prior pelvic surgery.
A doctor can diagnose bladder prolapse by:
Asking about your symptoms and medical history.
Doing a pelvic exam (while you’re lying down, standing, or straining).
Measuring how severe the prolapse is and which parts of the vagina are affected.
Other tests might include:
Cystoscopy (looking inside the bladder with a camera).
Urodynamics (testing how well the bladder works).
X-rays, ultrasound, or MRI to check the pelvic area.
Treatment depends on how severe the prolapse is and how much it bothers you. Options include:
No treatment: If the prolapse isn’t causing problems, you might not need treatment.
Kegel exercises: Strengthen the pelvic floor muscles.
Pelvic floor physical therapy: May include using a pessary (a device that supports the vagina).
Estrogen therapy: Helps strengthen vaginal tissues, especially after menopause.
Surgery is done to repair the prolapse and improve symptoms. It can be done through the vagina or abdomen. Types of surgery include:
Open surgery: A cut is made in the abdomen.
Minimally invasive surgery: Small cuts are made in the abdomen.
Laparoscopic surgery: Tools are inserted through small cuts in the abdomen.
Robot-assisted surgery: The surgeon uses robotic arms to perform the surgery.
If you have symptoms like a vaginal bulge, pain, or trouble with urination, talk to your doctor. Bladder prolapse can be managed with the right treatment!
