What is Bladder Prolapse?

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Bladder prolapse

Roughly about ten million American adults, the majority of whom are women, have problems controlling their bladders. The bladder is a hollow organ in the pelvis that stores urine. The pressure created when the bladder fills is responsible for the urge to urinate. The urine passes from the bladder and out the body through the urethra, during urination. In women, the front wall of the vagina supports the bladder. This wall can weaken or loosen with age. This condition is known as Bladder prolapse or Cystocele. This condition is also known as “fallen bladder”. Prolapse of the uterus and vagina becomes more common as women get older and is not often seen before the menopause. Event though there are many reasons for a bladder prolapse, the major reason is believed to be the child birth that causes considerable bodily stress that leads to the damage of the vaginal wall.

What are the reasons for a bladder prolapse?

The reasons that are believed to be responsible for a bladder prolapse are:

  • Childbirth: This is the major reason for a prolapsed bladder. The course of action during delivery is stressful on the vaginal tissues and muscles, which hold up a woman’s bladder.
  • 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.
  • Menopause: Generally, Prolapsed bladders are linked with menopause. Women’s bodies produce enough hormone estrogen, before menopause. This estrogen aids in keeping the muscles in and around the vagina strong. After menopause, as women’s bodies stop producing estrogen, those muscles become weak resulting some times in bladder prolapse.

 

What are the stages of a prolapsed bladder?

Prolapsed bladders are divided into four grades depending how far the bladder sags into the vagina.

  • Grade 1 (Mild): In mild cases of prolapse, only tiny portion of the bladder hangs down into the vagina.
  • Grade 2 (Moderate): In moderate cases of prolapse, the bladder sags enough so that it is could reach the opening of the vagina.
  • Grade 3 (Severe): In severe cases of prolapse, the bladder extends beyond the body through the vaginal opening.
  • Grade 4 (Complete): In the complete prolapse, the whole bladder sticks or extends out completely outside the vagina. Normally, this condition is linked with other forms of pelvic organ prolapse, such as uterine prolapse, rectocele, enterocele.

 

What are the symptoms of a prolapsed bladder?

Generally, the initial symptom for a prolapsed bladder is the development of tissue in the vagina that many women depict as something that feels like a ball.

Some other symptoms of a prolapsed bladder include the following:

  • Uneasiness or pain in the pelvis
  • Tissue extending beyond the vagina. The tissue may be tender and may bleed.
  • Trouble urinating
  • Immediately after urinating, there will be a feeling that the bladder is not empty. This condition is called ‘incomplete voiding’.
  • Stress incontinence (urine leakage during sneezing, coughing, exertion, etc)
  • Bladder infections that occur more often.
  • Painful intercourse (dyspareunia)
  • Low back pain.

A number of women may not experience or observe symptoms of a mild (grade 1) prolapsed bladder.

 

What are the treatments for prolapsed bladder?

A prolapsed bladder is seldom a life-threatening condition. Most cases that are mild can be treated without surgery, and most severe prolapsed bladders can be absolutely cured with surgery. Some of the home treatments for mild-to-moderate bladder prolapse include:

  • Heavy lifting or straining should be avoided.
  • The doctor may also suggest Kegel exercises to tighten the muscles of the pelvic floor. Kegel exercises can be done to treat mild-to-moderate prolapses or to complement other treatments for prolapses that are more serious. To do the kegel exercise, a woman should pretend as though she is trying to stop the flow of urine. Then, those muscles are pulled in and squeezed. Hold the squeeze for about 10 seconds, then rest for 10 seconds. Three or four sets of 10 contractions should be done on a daily basis.
  • Estrogen replacement therapy may be used for a prolapsed bladder to help the body strengthen the muscles in and around the vagina. In mild cases of prolapsed bladder, estrogen may be given in an effort to reverse bladder prolapse symptoms, such as vaginal weakening and incontinence. In severe cases of prolapse, estrogen replacement therapy may be used in addition to other types of treatment. Estrogen can be prescribed orally as a pill or topically as a patch or cream. Generally, topical application has less risk than the oral preparations. The application of estrogens to the anterior vagina and urethral area may be very useful in lessening urinary symptoms, such as necessity and occurrence, even in the face of prolapsed bladder.
  • Biofeedback: A doctor can suggest a specific set of exercises that can strengthen these muscles. These exercises may aid strengthen the muscles to reverse or relieve some symptoms related to a prolapsed bladder. A sensor is used to observe muscle activity in the vagina and on the pelvic floor which observes the muscular contractions at the time of the exercises. From this, the doctor may be able to find out whether the targeted muscles would benefit from the exercises.
  • Electrical stimulation: The physician may use a probe to the specific muscles within the vagina or on the pelvic floor. The probe is connected to a machine that measures and conveys small electrical currents that contract the muscles. These contractions assist strengthen the muscles. A less invasive kind of electrical stimulation that magnetically encourages the ‘pudendal nerve’ from outside the body will trigger the muscles of the pelvic floor that may help treat incontinence.

 

What is the surgical process for a prolapsed bladder?

  • Usually, severe prolapsed bladders necessitate surgery.
  • Based on the procedure, surgery can be done while the woman is under general, regional, or local anesthesia.
  • Prolapsed bladder surgery is generally done through the vagina, and the primary intention is to position the bladder in its correct position.
  • The bladder is fixed with an incision or cut in the vaginal wall.
  • The prolapsed area is sealed and the wall is strengthened.

 

What is the recovery time from the surgery?

For minor surgeries, many women are discharged home on the same day of surgery. Most women can expect to do normal activities after six weeks after the surgery. Yet, surgeons may recommend eliminating activities that cause straining for up to six months.

 

How to prevent a bladder prolapse?

  • In order to prevent a prolapsed bladder, a high-fiber diet and a daily intake of plenty of fluids are essential. This can reduce a person’s risk of developing constipation.
  • Too much strain during bowel movements should be avoided.
  • In order to reduce the chance of developing a prolapsed bladder, women with enduring constipation should request medical care.
  • Often, heavy lifting is linked with prolapsed bladder and should be avoided.
  • Obesity is another key factor for developing a prolapsed bladder. It is always good to maintain appropriate body weight to prevent several medical conditions. 
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