Bladder prolapse, also known as anterior vaginal wall prolapse, occurs when the bladder pushes against and through the front wall of the vagina. This condition is primarily caused by the weakening or straining of the tissues supporting the vaginal walls. As a result, the bladder may sag and press into the vaginal canal.
Symptoms of Bladder Prolapse
The severity of bladder prolapse symptoms varies depending on the extent and cause. Common signs include:
- A noticeable or palpable bulge at the vaginal opening
- A persistent urge to urinate
- Recurrent urinary tract infections (UTIs)
- A constant sensation of pressure or heaviness around the vaginal area
- Incomplete relief after urination
- Pain during or after sexual intercourse
- Lower back, pelvic, or vaginal pain
- Protruding tissue from the vaginal opening, which may cause discomfort or bleeding
- Discomfort when using tampons
- Difficulty initiating urine flow
Causes of Bladder Prolapse
Several factors can contribute to bladder prolapse, with one of the most common being the strain on the vagina during pregnancy and childbirth. Women who have had vaginal deliveries or complicated pregnancies are at higher risk. Other causes include:
- Aging
- Chronic constipation
- Obesity or being overweight
- Frequent heavy lifting or strenuous physical activity
- History of pelvic surgery
- Menopause
- Chronic coughing
- Multiple pregnancies (vaginal deliveries)
Stages of Bladder Prolapse
Bladder prolapse is categorized into stages based on its severity:
- Stage 1: The bladder slightly protrudes into the vaginal canal.
- Stage 2: The bladder descends far enough to nearly reach the vaginal opening.
- Stage 3: The bladder extends beyond the vaginal opening.
- Stage 4: The most severe form, where multiple pelvic organs, including the bladder, protrude outside the vaginal opening.
The Pelvic Organ Prolapse Quantification (POP-Q) system is often used to measure the prolapse in relation to the vaginal opening.
Diagnosis of Bladder Prolapse
Bladder prolapse is typically diagnosed through a medical history review and a pelvic exam. The doctor may ask the patient to assume specific positions to assess the extent of the prolapse. Additional diagnostic tests may include:
- Pelvic ultrasound
- X-rays
- Cystoscopy (examination of the bladder using a scope)
- Urodynamic testing to assess bladder function
Treatment for Bladder Prolapse
Not all cases of bladder prolapse require treatment, especially if symptoms are mild or non-disruptive. However, if urinary flow is obstructed or pressure and discomfort around the vaginal area are significant, treatment may be necessary.
Non-Surgical Treatments:
- Kegel exercises: Strengthen the pelvic floor muscles
- Pelvic floor therapy: Helps stretch and relax pelvic muscles to reduce pain
- Pessary device: A prosthetic inserted into the vagina to support the vaginal walls
Surgical and Medical Treatments:
- Medications: Prescription therapies may help strengthen the bladder.
- Surgical options: Open surgery, laparoscopic surgery, or minimally invasive procedures may be recommended to repair the prolapse and restore vaginal support.
Key Points to Remember:
- Bladder prolapse, also referred to as cystocele, occurs when the bladder shifts into the vaginal wall.
- This condition is more common in women, especially those with multiple pregnancies.
- Symptoms vary by individual, and treatment options depend on the severity of the prolapse.
