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Feel like you need to urinate? That’s your bladder telling you I’m full, please empty me – soon! Now imagine if you felt like you were constantly sitting on an egg. Or every time you lifted your baby you could feel your organs slipping out. Imagine feeling a constant tugging in your pelvis and pressure in your rectum. Imagine constantly going to the bathroom but never feeling the satisfaction of a completely empty bladder. If you sneeze, laugh or simply move you pee yourself. Suffering silently, feeling embarrassed, and anxious leaving your house, bladder prolapse is not something that will fix itself most get worse with time.
The front wall of the vagina supports the bladder, and it can weaken or loosen with age. Substantial bodily stresses such as childbirth can also damage this part of the vaginal wall. If it deteriorates enough, the bladder can prolapse, meaning it is no longer supported correctly and descends into the vagina.
Bladder prolapse symptoms can exhibit themselves in a variety of ways, commonly however the first symptom for many women with a prolapsed bladder is the feeling of something that feels like a ball in their vagina. Other symptoms of a prolapsed bladder include:
Childbirth is the most common cause of a prolapsed bladder. The childbirth delivery process is stressful on the vaginal tissues and muscles, which support a woman’s bladder.
Menopause: Estrogen, a hormone that helps maintain the strength and health of muscles in the vagina, is not produced after menopause.
Straining: Lifting heavy objects, straining during bowel movements, having a long-term condition that involves coughing, or having long-term constipation may damage the muscles of the pelvic floor.
If you notice any of the symptoms of a prolapsed bladder you should see your doctor. A prolapsed bladder is often coupled with prolapses of other organs. Hence it is important to see your doctor as soon as possible so that your situation can be evaluated, and treatment can begin to prevent the worsening of the condition. There are several treatments available to correct a prolapsed bladder.
The diagnosis will require a pelvic exam, usually by a gynaecologist, to diagnose a prolapsed bladder. A bladder that has entered the vagina will confirm the diagnosis.
In some cases, x-rays maybe used to rule out other possible causes of discomfort or urinary difficulty. After diagnosis, the gynaecologist may test muscles, nerves, and strength of the urine stream to help decide the most suitable type of treatment.
Cystoscopy (looking into the bladder with a scope) may also be done to identify treatment options. It has little risk and is tolerable for most women.
Prolapsed bladders (also called cystoceles) are divided into four grades based on how far the bladder sags into the vagina:
If there is no pain or discomfort, there may not be any need for medical or surgical treatment. You may be recommended to avoid heavy lifting or straining, and you should definitely begin a pelvic floor training routine such as Kegel exercises.
Compression garments such as SRC Restore Incontinence and Prolapse Underwear for Women with their patented Anatomical Support Panels, specifically the gusset panel, provide continuous even compression to the entire perineal area1 and have evidence2 that has shown a reduction in symptoms of mild uterine prolapse and bladder prolapse while wearing the SRC Restore compression garment.
As the bladder prolapse becomes more serious, your age and general health should be considered by the gynaecologist and/or pelvic health physical therapist.
Nonsurgical solutions for mild-to-moderate cases of prolapsed bladder include:
1. Kegel exercises to strengthen the muscles of the pelvic floor as well as to supplement other treatments for prolapses that are more serious.
2. Pelvic Floor Trainers - your gynaecologist or pelvic health physical therapist can recommend a pelvic floor training tool that can strengthen your pelvic floor muscles to reverse or relieve some symptoms related to a prolapsed bladder. The sensor in the tool can monitor the muscular contractions in the vagina and on the pelvic floor during the exercises, and your health care professional may be able to determine if your pelvic floor will benefit from the exercises. Finally, a doctor can apply a probe to electrically stimulate muscles within the vagina or on the pelvic floor. The resulting contractions can help strengthen the muscles. There are also pelvic floor trainers you can use yourself such as one here.
3. Pessary - a device that is placed within the vagina to hold the bladder in place, it must be removed and cleaned at regular intervals to prevent infection with some devices being designed to allow you to do it yourself. Estrogen cream is commonly used along with a pessary to help prevent infection and vaginal wall erosion. Pessaries are not for everyone as some women find them to be uncomfortable or irritating as they fall out.
4. Estrogen replacement therapy may benefit some women with bladder prolapse as it will assist in strengthening and maintaining muscles in the vagina. Estrogen replacement therapy may also be used along with other types of treatment.
Severe prolapsed bladder that can’t be managed with other treatments will require surgery. Prolapsed bladder surgery is usually performed through the vagina, to secure the bladder in the correct position, with some women going home the same day.
Different materials have been used to strengthen pelvic weakness associated with prolapsed bladder, however in recent times the findings around placing mesh through the vagina to repair pelvic organ prolapse has caused the FDA to say that the “risks may outweigh its benefits.” The use of mesh may still be appropriate in some situations and your surgeon should explain the benefits, risks and potential complications associated with surgery.
Your surgeon may recommend reducing or eliminating activities that cause straining for up to six months however many women return to their typical level of activity after just six weeks.
Sometimes you can reverse a mild case of bladder prolapse by doing exercises that strengthen your pelvic muscles. In other cases, the degree of the prolapse can increase over time as you age and this can occur more rapidly in some women than in others. Advanced or severe cases of prolapse usually do not respond to exercise or hormonal therapy. Surgery often improves pelvic organ prolapse.
To reduce your risk of bladder prolapse, you can:
Look after your pelvic floor and it will decrease the risk of and/or severity of bladder prolapse. Here are 2 amazing articles describing very different personal experiences