Bladder Prolapse

A prolapsed bladder is measured by grades:

Grade 1 – mild, the bladder droops only a short way into the vagina

Grade 2 – more severe, the bladder sinks into the vagina, as far as the opening of the vagina

Grade 3 – most advanced, the bladder bulges through the vagina opening

Causes

• Childbirth stretches the walls of the vagina which may weaken them

• Heavy lifting

• Strained bowel movements over many years

• Reduced estrogen levels. Estrogen helps keep vaginal walls toned, but after menopause estrogen levels drop and muscles around the vagina and bladder may weaken.

• Heredity

Symptoms

• Urinary incontinence - sudden, involuntary urination without warning and without control Dropped bladder can cause urethra to become stretched, increasing the chance of involuntary urination when laughing, sneezing, coughing or exercising.

• Pressure in the pelvic area, lower abdomen or lower back

• Difficulty urinating

• Frequent urge to urinate

• Frequent urinary tract infections because it's difficult to empty the bladder

• Pain during sexual intercourse

Treatment

• Avoiding lifting or straining

• Insertion of a device called a pessary. Made of plastic, rubber or silicone, a pessary comes in several sizes and is inserted into the vagina and positioned so that it pushes the bladder back into its correct position. A pessary must be removed periodically to avoid infection and irritation. Your doctor will teach you how to remove, clean and reinsert the pessary or it can be done on a regular basis by your doctor.

• Surgery is an option in more serious cases of cystocele. The bladder is moved back in place and secured through various surgical procedures.

• Kegel exercises to strengthen the muscles supporting the bladder and vagina.

• ERT – estrogen replacement therapy may help strengthen the vaginal wall. The risks however, may outweigh the benefits. ERT has been linked to increase risk uterine cancer.

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