This process can cause the bladder to move from its natural position and press into the vagina. A bladder prolapse may develop if a woman’s pelvic muscles become damaged. It is common case during pregnancy, labor, childbirth, or a previous pelvic surgery or are weakened by aging. In rare cases, a cystocele can be present at birth, and then it is called congenital cystocele. A cystocele may cause leaking of urine, especially during coughing, laughing, or jumping. It may also cause difficulty emptying the bladder, which may progress to a bladder infection known as cystitis. Exercises to strengthen the pelvic floor muscles, called Kegel exercises, may help relieve symptoms of a cystocele. A health professional may recommend use of a pessary, which is an instrument placed in the vagina to support the uterus. In severe cases, surgery may be needed as the only treatment for prolapsed bladder.
What is prolapsed bladder?
Childbirth and aging are two factors working against the female structure, because during birth, the muscles and skin of the birth canal, or vagina, are stretched and torn. They repair over time but are never exactly the same, and after that, as we age, all the muscles of our body thin and weaken. As a result of these effects, the walls of the vagina can commonly sag. The front wall of the vagina holds up the bladder, while the back wall holds the lower gut, or rectum. The womb takes up a spot in the middle, so all these organs are involved when the vagina relaxes too much. Many women have the feeling of pelvic pressure or trouble holding their urine immediately after childbirth, but for some, this feeling goes away only to return as they get older. These are the main signs of problem called pelvic relaxation. When severe, it can be difficult to hold any urine at all and extra force may be needed to move bowels. A prolapsed bladder, uterus, or rectum can occur. This means that part of these organs may slide from its normal position to partial exposure outside your body. A fallen organ cannot repair itself, so contact your healthcare provider as soon as you know you have a problem. You should watch for signs like urine leakage, feeling of a ball shaped formation or pressure in the area, or pain or soreness of exposed tissue.
Signs and symptoms for prolapsed bladder
In mild cases of prolapsed bladder, it is possible to not even notice a bulge. When signs or symptoms do present themselves, they may include feeling of fullness or pressure in your pelvis and vagina, and this is especially when standing for long periods of time. Woman may also feel increased discomfort when she strain, cough, bear down or lift. A bulge of tissue that, in severe cases, protrudes through vaginal opening is also common symptom. The resulting soft bulge may feel walnut or even grapefruit-sized, and often goes away when patient lie down. Some women also reported a feeling that they have not completely emptied their bladder after urinating. Loss of urinary control with coughing, laughing or sneezing is called stress incontinence and is also common symptom for prolapsed bladder In severe cases, patient may not be able to control urination at all. The main symptom for recurrent bladder infection is pain or urinary leakage during sexual intercourse. When other organs join the bladder in moving into the space in the front part of the vagina, the condition is called anterior prolapse.
During an exam, you may be asked to cough or push to help show the problem, and tests of the nerves, muscles, and urine will help tell if exercises or surgery is needed. In mild cases, muscle tightening exercises may be all that is needed, while hormones, such as estrogen, are helpful in older women. In serious cases, surgery may be needed to put the organs back into their proper working location, where the womb is often removed with this surgery because of the pressure it puts on the bladder. In the older women who may not be able to have surgery, other treatments may be recommended for prolapsed bladder.
Causes of prolapsed bladder
Pregnancy and childbirth are the most common causes of a cystocele as you could already hear. This is because the muscles and ligaments that support and hold woman’s vagina in place may become stretched and weakened during labor and delivery. For this reason, cystoceles are more common after woman had multiple pregnancies. However, not everyone who has had a baby develops a cystocele. Some women have very strong supporting muscles and ligaments in the pelvis and may never have any problem. Women who have only Caesarean section deliveries do not develop prolapse. Bladder prolapse also may be caused by straining your pelvic floor muscles through being overweight or obese, repeated heavy lifting, straining with bowel movements, or due to chronic cough or bronchitis.
Treatment for prolapsed bladder
Treatment depends on the severity of each condition on its own. Mild cases are those with few or no obvious symptoms. These cases may require no treatment or simple self-care measures such as special exercises to strengthen your pelvic floor muscles. If self-care measures are not effective, treatment may include process called pessary. Vaginal pessary is a plastic or rubber ring that is inserted in the vagina to support the bladder by pushing it up and back into place. In some cases, the doctor may recommend using a large tampon or vaginal diaphragm instead of a pessary. Most women who use pessaries do so as a temporary alternative to surgery, but sut some women may use pessaries for years. Estrogen therapy could also help in some cases. The doctor may recommend using estrogen, either orally or in a vaginal cream, especially if you have already experienced menopause. This is because estrogen, which helps keep pelvic muscles strong, decreases after woman enters menopause.
When is surgery necessary for prolapsed bladder?
Severe or especially uncomfortable cases of cystocele may require special surgery. This surgery is elective and designed to relieve symptoms related to the cystocele or prolapsed bladder. In most cases, surgery consists of a vaginal repair, and in this procedure, a surgeon elevates the prolapse back into place and tightens the muscles and ligaments of woman’s pelvic floor. This procedure may require even removal of some stretched tissue. While the benefits of this type of surgery can last for many years, there is also some risk of recurrence. This is partly because pelvic muscles and nerves continue to weaken as you age and this is natural process that cannot be stopped. If the cystocele recurs, you may need surgery again, although it is more difficult to get a good result the second time. In some cases, especially where the tissues needed to support the vagina are unusually thin, using a special type of tissue graft helps thicken the vaginal tissues. The goal is to increase vagina support. In other cases, doctor may recommend a hysterectomy, which is removal of the uterus, to help correct the problem and prevent recurrence of the same. When possible, you should avoid surgical treatment if you have a large cystocele until you are done having children. If the prolapse is so uncomfortable that you need a vaginal repair, you can still have children, though a Caesarean delivery is recommended after that surgery. It is very common question what is the surgical and recovery time. Each person that undergo surgery because of bladder prolapse should talk with the doctor about all benefits and risks for this surgery type. Then, doctor and patient should together decide if surgery is the best option. The fact is that about one hour of surgery is necessary to position the bladder back into its normal position. The incisions are almost always limited to the vaginal area, and post-operative discomfort is not generally significant for these patients. Most patients are discharged to home morning after the operation. About 30% of patients will need to be discharged home with a catheter, which will be removed five to seven days later in the doctor’s or surgeon’s office. You should avoid heavy lifting, heavy exercise, or sexual activity for six weeks. Walking, including stairs is fine immediately after the operation for prolapsed bladder. However, after you came home, it would be the best to follow directions that your doctor told you. Only that way you will heal as it is recommended and probably avoid recurrent bladder prolapse.
Dealing with incontinence
The doctor may recommend collagen injections in the urethra, the tube from the bladder through which urine exits the body, to treat incontinence caused by a cystocele. During a collagen injection, the protein is injected through a narrow tube called cytoscope into the lining of urethra. This helps add bulk to the tissues of urethra, helping to close the gap that allowed urine to leak. Evaryone with problem of incontinence should be aware that is common world wide problem and nothing you should be ashamed of. Talk about this problem with your doctor and seek the best solution.
Who is at risk for bladder prolapse?
Bladder prolapse tends to occur in older women who have had multiple children, and particularly after menopause, some women may notice that their bladder has fallen, which could lead to prolapsed bladder.