Bladder prolapse, also known as cystocele, is a common condition in women that involves a stretching or weakening of the pelvic floor muscles that support the bladder. Once this occurs, the bladder gradually sags into the vagina and may even protrude through its opening, causing urinary problems. Normally, in women, the bladder is held in position by supportive pelvic floor muscles and ligaments. When the muscles and tissues are stretched and weakened, the bladder can sag through the ligaments and into the vagina, resulting in bladder prolapse.
Causes of Bladder Prolapse
Bladder prolapse can be caused by many different factors, the most common being stress placed on muscles during childbirth. Women who have had multiple vaginal births are at a higher risk for developing prolapse. Bladder prolapse may become more severe after menopause because the drop in estrogen affects the strength of the pelvic tissue. Other less common causes of this condition include:
- Heavy lifting
- Chronic cough
- Frequent straining during bowel movements
Bladder prolapse may also be caused by a complication of previous pelvic surgery.
Symptoms of Bladder Prolapse
Women with bladder prolapse often experience many troubling symptoms such as frequent urination and incontinence. Other symptoms that may occur as a result of this condition include:
- Lack of relief after urinating
- Urinary tract infections
- Pain in the vagina, pelvis or abdomen
- Heaviness or pressure in the vaginal area
- Painful Intercourse
Bladder prolapse may also cause painful and difficult bowel movements. Patients with mild cases of bladder prolapse may not experience any symptoms at all.
Diagnosis of Bladder Prolapse
A doctor can usually diagnose bladder prolapse with a pelvic examination. The following tests may also be required to further determine problems in other parts of the urinary system:
When a pelvic examination is inconclusive, a voiding cystourethrogram may be required. This test involves a series of X-rays that are taken during urination and show the shape of the bladder, which helps to identify obstructions blocking the normal flow of urine.
Treatment of Bladder Prolapse
Treatment for bladder prolapse varies, depending on the severity of the condition. Treatments may include:
- Kegel exercises to strengthen the pelvic floor muscles
- Insertion of a pessary device to provide better support for the organs
- Surgery for severe cases
In bladder prolapse surgery, the vaginal wall is surgically repaired or reinforced and the bladder is pushed back into its normal position. In some cases, bladder prolapse may reoccur, even after surgery.
Complications of Bladder Prolapse
Left untreated, bladder prolapse worsens with time and may lead to urinary retention and eventual kidney damage; although these complications are considered rare. Most cases of bladder prolapse can be effectively treated without the need for surgery.