prolapsed Bladder is when the ligaments that hold your bladder up and the muscle that connects your vagina to your bladder stretch or weaken, enabling the bladder to drop into your vagina. It is also known as cystocele, herniated, dropped, or fallen bladder.
The bladder is maintained in place by a “hammock” of supportive pelvic floor muscles and tissue in normal women. The bladder can drop and protrude through this layer and into the vagina when these tissues are strained and/or weak. Bladder prolapse, also known as cystocele, is the result of this. In severe situations, the prolapsed bladder might protrude through the vaginal opening. It can even extend (drop) into the vaginal opening on occasion. Bladder prolapse is a typical occurrence in females. Bladder prolapse symptoms can be uncomfortable, but they can be managed.
There are three types of bladders prolapse:
- Mild: The bladder merely protrudes a few millimeters into the vaginal canal.
- Moderate: The bladder descends to the vaginal entrance.
- Severe: The bladder protrudes through the vaginal opening.
Causes of prolapsed bladder
Muscles, ligaments, and connective tissues make up your pelvic floor, which supports your bladder and other pelvic organs. Over time, particularly as a result of damage from childbirth or chronic straining, the connections between your pelvic organs and ligaments can deteriorate. When this happens, your bladder may drop lower than usual and bulge into your vaginal opening (anterior prolapse).
The following are some of the causes of pelvic floor stress:
- Pregnancy and childbirth by vaginal birth
- Obesity or being overweight
- Regular heavy lifting
- Constipation is causing you to strain.
- Bronchitis or a persistent cough
Symptoms of prolapsed bladder
The presence of tissue in the vaginal area, which many women describe as feeling like a ball, is frequently the initial symptom of a prolapsed bladder.
Other signs and symptoms of a prolapsed bladder include:
- Pelvic dissatisfaction or discomfort
- Protruding tissue from the vaginal canal (The tissue may be tender and may bleed)
- Urination problems
- Feeling as if your bladder isn’t empty after you’ve urinated (incomplete voiding)
- Incontinence due to stress (urine leakage during sneezing, coughing, or exertion)
- Frequent bladder infections
- Intercourse that is painful (dyspareunia)
- Pelvic or lower back pain, fullness, heaviness, or discomfort. When the person stands, lifts, coughs, or as the day develops, the sensation may worsen
- Tampons or applicators are difficult to implant
- The bladder pushes its way into or out of the vaginal opening
- Heaviness or pressure in the vaginal area
Risk factors of prolapse bladder
The factors that increase the risk of having a prolapsed bladder are:
- Childbirth– Bladder prolapse is more likely in women who have had a vaginal or instrument-assisted delivery, repeated pregnancies, or infants with high birth weight.
- Aging– As you become older, your chances of developing anterior prolapse rise. This is especially true after menopause, when your body’s production of estrogen, which aids in the maintenance of a robust pelvic floor, drops.
- Hysterectomy– It’s possible that having your uterus removed causes pelvic floor weakness, although this isn’t usually the case.
- Genetics– Some women are born with poorer connective tissues, increasing their risk of anterior prolapse.
- Obesity– Obese or overweight women are more likely to experience anterior prolapse.
Diagnosis of prolapsed bladder
The following tests may be used to diagnose anterior prolapse:
- Pelvic examination– It’s possible that you’ll be examined while lying down or standing up. During the examination, your doctor will search for a tissue protrusion in your vaginal wall, which indicates pelvic organ prolapse. You’ll probably be asked to bear down as if you’re having a bowel movement to see how much this influences the degree of prolapse. You’ll be asked to contract your pelvic floor muscles as if you’re trying to stop the flow of urine to test their strength.
- Urine and bladder testing– You may be checked to assess how well and thoroughly your bladder empties if you have substantial prolapse. If you seem to be retaining more pee in your bladder than is typical after urinating, your doctor may run a test on a urine sample to search for signs of a bladder infection.
- Questionnaire– You may be asked to complete a form that will assist your doctor in determining your medical history, the severity of the prolapse, and how much it impacts your quality of life. This data also aids in making treatment decisions.
Treatment for Prolapsed bladder
Treatment is determined by whether or not you have symptoms, the severity of your anterior prolapse, and whether or not you have any other diseases, such as urinary incontinence or several types of pelvic organ prolapse.
Mild instances, with few or no visible symptoms, usually do not require treatment. Your doctor may advise you to wait and see, with periodic appointments to monitor the prolapse.
If you have signs of anterior prolapse, your first line of defense is to:
- Exercises to strengthen the muscles of the pelvic floor
These exercises, also known as Kegels, strengthen your pelvic floor muscles, allowing them to better support your bladder and other pelvic organs. You can get instructions on how to execute these exercises from your doctor or physical therapist, and they can also help you assess if you’re doing them correctly.
When taught by a physical therapist and reinforced with biofeedback, Kegel exercises may be most effective at alleviating symptoms. Biofeedback entails the use of monitoring devices to guarantee that you’re tightening the right muscles for the right amount of time and with the right intensity. These exercises may make you feel better, but they are unlikely to reduce the size of the prolapse.
- A device that assists (pessary)
The bladder is supported with a vaginal pessary, which is a plastic or rubber ring implanted into the vagina. The extra support provided by a pessary does not heal or cure the actual prolapse, but it can assist ease symptoms. Your doctor or other health care professional will fit you for the device and show you how to clean and replace it on your own. Pessaries are used by many women as a temporary alternative to surgery, and they are also used by other women when surgery is too hazardous.
Medication for prolapse bladder
For a prolapsed bladder, estrogen replacement treatment may be utilized to assist the body rebuild the tissues in and around the vagina. Not everyone can benefit from estrogen replacement therapy (such as in people with certain types of cancer). After menopause, women’s bodies stop producing as much estrogen naturally, and the vaginal muscles may weaken as a result. Estrogen may be administered to treat bladder prolapse symptoms such as vaginal weakness and incontinence in mild cases of prolapsed bladder. Estrogen replacement therapy may be used in conjunction with other treatments for more severe cases of prolapse.
Estrogen can be taken orally or applied topically as a patch or cream. The cream has a low systemic absorption rate and has a strong effect where it is administered. The danger of topical administration is lower than that of oral preparations. Even in the presence of a prolapsed bladder, estrogen administration to the anterior vaginal and urethral area may be highly effective in relieving urine symptoms including urgency and frequency.
Surgical treatment for prolapse bladder
If the cystocele is moderate or severe, reconstructive surgery to restore the bladder’s natural position may be required. This operation can be performed in a number of methods, one of which is an anterior repair. An anterior repair entails cutting the vaginal wall and tightening the tissue that connects the bladder to the vagina. Another option for more severe prolapse is to use a robotic or laparoscopic procedure to implant a synthetic material into the abdomen. This method may provide additional support to the tissue and aid in the prevention of illness recurrence.
The patient is frequently discharged from the hospital the same day as the procedure. It normally takes four to six weeks for a person to recover completely.
Biofeedback is another procedure for prolapsed bladder. Muscle activity in the vaginal and pelvic floor is monitored using a sensor. Exercises to strengthen these muscles can be recommended by the doctor. These exercises will help you strengthen your muscles and ease some of the symptoms of a prolapsed bladder. The sensor can track muscular contractions during the exercises, allowing the doctor to see if the exercises are beneficial to the targeted muscles.
Another treatment option for a prolapsed bladder is electrical stimulation. A probe can be used to target specific muscles within the vaginal canal or on the pelvic floor by a clinician. The probe is connected to a device that measures and sends small electrical currents to the muscles to contract them. Muscles are strengthened by these contractions. Magnetically stimulating the pudendal nerve from outside the body is a less intrusive sort of electrical stimulation. This stimulates the pelvic floor muscles, which may aid in the treatment of incontinence.
For women who never intend to have sexual intercourse again, surgery to stitch the vagina closed and shorten it so it no longer bulges is nearly 100 % effective.
After treatment of prolapse bladder
Nonsurgical therapy may be all that is required to successfully treat a prolapsed bladder in mild situations.
Some women will require a second procedure if the first failed, the cystocele resurfaced, or another pelvic floor issue developed. Women who are older, smokers, diabetics, or have had a hysterectomy are more prone to have problems.
Prevention of prolapse bladder
A high-fiber diet and a daily intake of plenty of water can help avoid a prolapsed bladder by lowering the risk of constipation. If at all possible, avoid straining during bowel motions. Women who have been constipated for a long time should seek medical help to reduce the risk of getting a prolapsed bladder.
Heavy lifting has been linked to bladder prolapse and should be avoided if at all possible.
Obesity increases the chances of a prolapsed bladder. Weight loss may help to prevent the onset of this illness.
You should have a thorough discussion with your surgeon before undergoing surgery. You should educate yourself on the risks, advantages, and other options for cystocele surgery. It’s critical that you provide informed consent. Only when your doctor has answered all of your questions is this possible.
If the prolapse is left untreated, it may remain the same or worsen over time. Severe prolapse might induce renal blockage or urinary retention in rare situations (inability to pass urine). Kidney damage or infection may result as a result of this.
