If you've noticed a feeling of heaviness in your pelvis or a bulge near your vaginal opening, you might be experiencing a prolapsed bladder. This condition, also called a cystocele, happens when the bladder shifts out of place and presses into the vaginal wall. It's often due to weakened pelvic floor muscles.
While it can sound alarming, a prolapsed bladder is more common than you might think. It's especially common after childbirth, menopause, or years of heavy lifting. Some women don’t even know it’s happening until a routine check-up. For others, the symptoms, like pressure, discomfort, or urinary problems, can start to interfere with daily life.
Fortunately, there are several treatment options available. These range from simple lifestyle changes to supportive devices and, in some cases, surgery.
What Causes Weak Pelvic Floor Muscles?
Several factors can weaken your pelvic floor over time, including:
- Childbirth, especially vaginal deliveries or multiple births
- Lower estrogen levels from aging or menopause
- Chronic coughing, which increases abdominal pressure
- Constipation
- Heavy lifting
- Having extra body weight
- Prior pelvic surgery
- Genetic factors causing weak connective tissue
What Are Prolapsed Bladder Symptoms?
A prolapsed bladder doesn't always cause noticeable symptoms, especially in mild cases. You may not even realize anything is wrong until it's found during a routine exam. However, as the bladder drops further into the vaginal wall, it can begin to affect your comfort. Symptoms may also become more noticeable and might include:
- A feeling of pressure or fullness in the vagina
- A bulge that you can feel or see at the vaginal opening
- Leaking urine
- Trouble starting or finishing a stream
- Feeling like your bladder isn't emptying completely
- More frequent urinary tract infections
- Discomfort during sex
- Lower back or pelvic pain
- A feeling like something is falling out
These symptoms often worsen when you're active or standing and improve when lying down. They may also become more frequent or severe as the prolapse worsens.
How Is a Prolapsed Bladder Diagnosed?
Your doctor will perform a pelvic exam, which may involve asking you to cough or bear down so they can see the extent of the prolapse. In some cases, additional tests may be done, such as:
- Bladder function tests
- MRI or ultrasound imaging to evaluate pelvic anatomy
Bladder prolapse is grouped into stages based on how far the bladder has dropped into the vagina:
- Stage 1: Mild drop into the vaginal wall, often with no symptoms or just slight pelvic pressure.
- Stage 2: Bladder reaches the vaginal opening. You may feel pressure, notice a bulge, or have trouble emptying your bladder.
- Stage 3: The bladder bulges out of the vaginal opening. Symptoms can include a visible bulge, urine leakage, frequent infections, and discomfort during sex.
- Stage 4: The entire bladder is outside the vaginal opening. This stage causes major discomfort and usually requires surgery.
How Is It Treated?
Treatment depends on how severe the prolapse is and how much it's affecting your life.
1. Lifestyle changes and exercises
Pelvic floor exercises (Kegels) will help strengthen the muscles supporting your bladder. It is also recommended to:
- Avoid straining when lifting heavy objects or coughing
- Treat constipation to ease bowel movements
- Maintain a healthy weight
2. Pessary treatment
A pessary is a small, removable device placed in the vagina to support the bladder and vaginal walls. It's a nonsurgical treatment option that many women use successfully. Your doctor will fit the right size for you and teach you how to remove, clean, and reinsert it.
3. Vaginal estrogen
For postmenopausal women, low-dose vaginal estrogen can help improve vaginal tissue health. It doesn't reverse the prolapse but may relieve some urinary symptoms and improve comfort with pessary use.
4. Surgery
If symptoms are severe or don't improve with other treatments, surgery may be an option. Procedures typically involve lifting and securing the bladder and supporting vaginal tissues. Surgery can be performed in several ways: through the vagina, the abdomen, or using minimally invasive methods like laparoscopic or robotic techniques.
When to See a Doctor
Whether you're just starting to notice symptoms or exploring options for relief, scheduling an appointment with an experienced urologist is the first step. They'll help you choose the best management plan based on your situation and treatment goals.
Don't live with a prolapsed bladder any longer - schedule an appointment today!