Bladder Prolapse Overview

The bladder is naturally supported by the muscles of the pelvic floor, which help keep it in its proper position. Bladder prolapse, or cystocele, occurs when the bladder shifts out of place and protrudes into the vaginal wall. This condition is typically caused by weakened or damaged pelvic floor tissues.

Common Symptoms of Bladder Prolapse

Bladder prolapse most frequently affects women, often as a result of the strain placed on the pelvic floor muscles during childbirth. When the bladder bulges into the vaginal canal, it can lead to symptoms such as:

  • Urinary incontinence
  • Pain or discomfort during sexual activity
  • Frequent or urgent need to urinate
  • A sensation of incomplete bladder emptying, even after urination
  • Visible tissue protruding from the vaginal opening
  • Pelvic pain or pressure
  • Recurring urinary tract infections (UTIs)
  • A feeling of heaviness or fullness in the vaginal area

In some cases, individuals with bladder prolapse may not experience any noticeable symptoms, and the condition may be discovered during a routine physical examination.

Seeking Medical Attention

Anyone experiencing symptoms of bladder prolapse should consult a urologist for an evaluation. Identifying the source of discomfort is essential for determining the most effective treatment plan.

Additional Diagnostic Tests

Diagnosing bladder prolapse may require more than a physical examination, especially for more complex cases. A urologist may recommend diagnostic tests to assess bladder function and the condition of the pelvic floor, including:

  • Urodynamic testing
  • Cystoscopy
  • Ultrasound
  • X-ray
  • MRI

These tests can help determine the severity, or grade, of the prolapse, which ranges from 1 to 4:

  • Grade 1: Mild prolapse, with slight descent of the bladder into the vagina.
  • Grade 2: Moderate prolapse, with the bladder reaching the vaginal opening.
  • Grade 3: Severe prolapse, where the bladder protrudes outside the vaginal entrance.
  • Grade 4: Complete prolapse, with the bladder fully extended outside the vagina.

Treatment Options for Bladder Prolapse

For mild cases, non-surgical interventions are often effective. Avoiding activities that strain the pelvic floor and performing targeted pelvic floor exercises can help improve symptoms. For more significant prolapse, further treatments may be recommended, including:

Estrogen Replacement Therapy

Estrogen helps strengthen pelvic floor muscles and can be particularly effective for postmenopausal women who may have reduced hormone levels. This therapy can aid in tightening and supporting the tissues.

Pessary Use

A pessary is a removable device that supports the bladder and keeps it in place. Patients or healthcare providers can insert and clean the pessary regularly.

Surgical Repair

If conservative treatments do not provide relief or if the prolapse is severe, surgical intervention may be necessary. Surgical repair involves reconstructing and reinforcing the pelvic floor tissues to restore bladder support. Although surgery carries more risks than non-surgical treatments, it can offer long-lasting relief and symptom improvement.

Schedule a Consultation

To find the most suitable treatment for your case of bladder prolapse, reach out to your local urologist to schedule an appointment and discuss your options.

Sources:

https://www.urologyhealth.org/urologic-conditions/bladder-prolapse-(cystocele) https://www.webmd.com/women/guide/prolapsed-bladder#1