Pelvic Organ Prolapse

Under normal conditions in women, the bladder is held in place by a “hammock” of supportive pelvic floor muscles and tissue. When these tissues are stretched and/or become weak, the bladder can drop and bulge through this layer and into the vagina. This results in bladder prolapse, also called cystocele.

In severe cases, the prolapsed bladder can appear at the opening of the vagina. Sometimes it can even protrude (drop) through the vaginal opening. Bladder prolapse is common in women. The symptoms of bladder prolapse can be bothersome, but it can be treated.

Causes of bladder prolapse

The following factors are commonly associated with causing a prolapsed bladder:

• Childbirth: The delivery process is stressful on the vaginal tissues and muscles, which support a woman’s bladder. This is the most common cause of prolapse.
• 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.

Symptoms of bladder prolapse

The first symptom that women with a prolapsed bladder usually notice is the presence of tissue in the vagina that many women describe as something that feels like a ball.

Other symptoms of a prolapsed bladder include the following:

• Discomfort or pain in the pelvis.
• Tissue protruding from the vagina (tissue may be tender and may bleed).
• Difficulty urinating.
• A feeling that the bladder is not empty immediately after urinating (incomplete voiding).
• Stress incontinence (urine leakage during sneezing, coughing or exertion).
• More frequent bladder infections.
• Painful intercourse.
• Low back pain.

How is a prolapsed bladder treated?

Depending on the severity of your specific prolapse there are a variety of treatment options that may be considered. Please consult with your urologist to determine the best treatment for you.

Treatment options include:

• Pessary – a device that is placed with the vagina to hold the bladder in place.
• Estrogen replacement therapy – helps strengthen and maintain vaginal muscles.
• Kegel exercises – exercises used to tighten the muscles of the pelvic floor.
• Surgery – bladder will be surgically secured to the correct position.