bladder prolapse

Bladder prolapse , also called cystocele and fallen bladder, is a disorder than can occur when the wall between the vagina and bladder weakens, causing the bladder to drop out of position and bulge into the vagina.

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


The bladder prolapses into the vagina because the muscle tissue that seperates the vagina from the bladder stretches and weakens. This can be caused by:

  • 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


  • Urinary incontinence - sudden, involuntary urination without warning and without control. A fallen 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


Depending on your overall health, and the severity of the problem, treatments for prolapsed bladder include:

  • 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 bladder prolapse. The bladder is moved back in place and secured through various surgical procedures. If you are considering surgery, you need to read this article about transvaginal mesh 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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