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This article was co-written by Lacy Windham, MD. Dr. Windham is a Board Certified Obstetrician & Gynecologist in Tennessee. She attended medical school at the University of Tennessee Health Science Center in Memphis and completed her residency at East Virginia School of Medicine in 2010 for which she was awarded the Distinguished Residency in Obstetrics and Gynecology, Doctor of Obstetrics and Gynecology. Best Resident in Oncology and Best Resident Doctor.
There are 17 references cited in this article that you can view at the bottom of the page.
This article has been viewed 15,813 times.
A condition in which a woman’s bladder moves out of position and swoops down into the vagina is called “prolapsed bladder.” Anatomically, the bladder is located between the pubic bone (anterior) and the uterus (posterior) and above the vagina. Bladder prolapse, also known as bladder hernia, occurs when the vaginal wall muscles weaken and are not able to hold the pelvic organs in place. In this case, the bladder protrudes or retracts into the vagina. [1] X Trusted Source Mayo Clinic Go to Source About 11% of women need surgery to correct bladder prolapse. [2] X Research Source Bladder prolapse can be uncomfortable and uncontrollable, so it’s important to diagnose and correct symptoms as quickly and effectively as possible. [3] X Cleveland Clinic Trusted Source Go to Source
Steps
Know the symptoms of bladder prolapse
- This sensation is considered a sign of serious bladder prolapse.
- If you have a prolapsed bladder, you’ll feel more pain, pressure, or discomfort when you cough, sneeze, exert yourself, or put pressure on your pelvic floor. Then you need to clearly describe to the doctor.
- If you have a prolapsed bladder, you will feel as if something has fallen out of your vagina.
- Watch for any changes in urination, including difficulty initiating urination, inability to urinate (also known as urinary retention), and frequent urination.
- Observe the frequency of bladder infections or urinary tract infections (UTIs). “Frequent” was defined as having more than one UTI in a six-month period. Women with bladder prolapse are also more likely to have bladder infections, so you need to be very mindful of the frequency of UTIs.
- If painful intercourse is new, and you recently gave birth vaginally, the cause is likely to be bladder prolapse. In this case, you need to see a doctor as soon as possible.
- However, if you notice any of the above symptoms, you should see your general practitioner or gynecologist.
- Usually, you don’t need treatment if you don’t have symptoms.
Find out what causes bladder prolapse
- Women who have been pregnant, especially women who have had multiple vaginal deliveries, are at increased risk for prolapse. Even women who have had a caesarean section can experience this condition.
- Note that the drop in estrogen persists even if you enter menopause in an unnatural way, such as by having your uterus and/or ovaries removed. These surgeries not only damage the pelvis but also affect estrogen levels. So even if you’re younger than menopausal women and in good health, you can still be at risk for bladder prolapse. [17] X Trusted Source Mayo Clinic Go to Source
- Lifting very heavy objects (including children)
- Chronic and severe cough
- Constipation and straining when going to the toilet
- You can tell if a person is overweight or obese by their body mass index (BMI), a measure of body fat. BMI is calculated by dividing body mass in kilograms by the square of height in meters. A BMI between 25-29.9 is considered overweight, and greater than 30 is considered obese. [20] X Trusted Source Centers for Disease Contrp and Prevention Go to source
Diagnosis of bladder prolapse
- Provide complete information to the doctor, including medical history and detailed description of symptoms of the disease.
- Bladder prolapse was diagnosed as prolapse. [22] X Trusted Source National Institute of Diabetes and Digestive and Kidney Diseases Go to source
- In some cases, in addition to a regular gynecological exam, your doctor may have to do additional tests while you’re standing. This helps the doctor accurately assess the state of bladder prolapse in each different position.
- If you notice bladder prolapse in the back wall of your vagina, your doctor will perform a rectal exam. This step helps the doctor determine the strength of the muscle. [23] X Research Sources
- You don’t need to prepare for this test in advance, and it doesn’t take long. You’ll only feel some discomfort during your pelvic exam, but for many women this is just a routine check-up like taking a Pap smear.
- Bladder manometry measures the amount of urine in the bladder when you start to feel the urge to urinate, when the bladder feels “full,” and when the bladder is actually full [24] X Research Source
- Your doctor will ask you to urinate into a container connected to a computer that takes the measurement. You will then lie down on an examination table where the doctor will place a thin, flexible urinary catheter into your bladder.
- A urodynamic measurement is a series of different tests that include measuring urine flow, i.e. the time it takes to urinate, the time it takes to complete, and the amount of urine released. In addition, urodynamic measurement also includes a bladder pressure test as described above, an excretory test, and a urine discharge phase.
- During most urodynamic tests, your doctor will place a thin, flexible urinary catheter in place while you urinate. Special sensors will collect data for the doctor to analyze.
- Urinalysis – In this test, the urine will be tested to detect an infection (such as a UTI). The doctor will also check the bladder to see if the bladder is completely empty after urinating by inserting a urinary catheter into the urethra to drain urine and measuring the amount of urine remaining after voiding (PVR). If the PVR is more than 50-100 ml, it is considered as urinary retention, one of the symptoms of bladder prolapse. [25] X Trusted Source Mayo Clinic Go to Source[26] X Research Source
- PVR Ultrasound – An ultrasound test that emits sound waves that, when reaching the bladder, bounce off the ultrasound machine, creating an image of the bladder. The image also shows the amount of urine remaining in the bladder after excretion. [27] X Trusted Source National Institute of Diabetes and Digestive and Kidney Diseases Go to source
- Urethroscopy X-ray (VCUG) – This is a test that uses X-rays during urination to look at the bladder and assess its condition. VCUG displays bladder shape and analyzes urine flow to detect obstruction if present. This test can also be used to diagnose urinary incontinence that is masked by prolapse. The physician needs to make these two diagnoses, as the patient also needs surgical treatment for urinary incontinence in addition to treatment for prolapse (if surgery is needed). [28] X Research Sources[29] X Trusted Source National Institute of Diabetes and Digestive and Kidney Diseases Go to source
- Grade 1 bladder prolapse is mild. If you have grade 1 prolapse, only part of your bladder prolapses into your vagina. You may experience some mild symptoms such as mild discomfort and urinary discharge, but some women have no symptoms at all. Some remedies include Kegel exercises, rest, avoidance of heavy lifting and overstretching. If you’re post-menopausal, you may want to consider estrogen replacement therapy.
- Grade 2 bladder prolapse is moderate. At this point, the entire bladder prolapses into the vagina. They can drop down near the vaginal opening. Symptoms such as discomfort and urinary incontinence are moderate. This may require surgery to correct the position of the bladder, but you can still correct symptoms with a vaginal lift (a small plastic or silicone device that is inserted into the vagina to fix the vaginal wall). [32] X Research Source
- Grade 3 bladder prolapse is severe. During this stage, part of the bladder protrudes from the vaginal opening. Symptoms of discomfort and urinary incontinence become severe. Treatment includes surgical correction of prolapse and/or the use of a vaginal lift similar to grade 2 prolapse.
- Grade 4 prolapse is extremely severe. At this point, the entire bladder prolapses outside the vaginal opening. Then you may experience some other more serious problems including uterine and rectal prolapse.
Bladder prolapse treatment
- Keep in mind that your doctor may recommend that you stop certain activities, such as weightlifting or those that strain your pelvic muscles. However, you can still exercise regularly. [34] X Research Source
- You should also consider how your symptoms affect your quality of life in order to make treatment decisions. For example, you may have severe bladder prolapse but not be affected by the accompanying symptoms. In this case, you can talk to your doctor about some gentler treatments. In other cases, you may have a mild prolapse, but the symptoms are very painful or inconvenient. You can then consult your doctor about some stronger treatment methods.
- Stretch, or contract, the pelvic floor muscles. This is the muscle group used to stop the flow of urine while excreting.
- Squeeze for about five seconds, then relax for about five seconds.
- Gradually increase the time by ten seconds.
- The goal is to do 3 to 4 reps with 10 repetitions each
- Vaginal lifts can be uncomfortable, and some women experience the ring falling out. In addition, they can cause ulcers (if not sized properly) and vaginal infections (if not removed and cleaned monthly). You need to use an estrogen cream to avoid damaging the vaginal wall.
- Despite some limitations, a vaginal lift is an effective alternative, especially if you want to delay or can’t have surgery. Talk to your doctor, and consider the pros and cons in your case
- Estrogen therapy poses some risks. Women with certain cancers should not use estrogen, and you should discuss the potential risks and benefits of this method with your doctor. In general, topical estrogen treatments are generally less risky than “systemic” oral estrogen treatments.
- Vaginal cosmetic surgery is a common surgical treatment. The doctor will reposition the bladder, then may tighten or strengthen the vaginal muscle group so that the organs are in the correct position. You may want to consider several other types of surgery, and your doctor will recommend the best type of surgery for you. [39] X Research Sources
- Your doctor will explain the surgical procedure, the risks and benefits, and some potential complications before surgery. Potential complications include UTI, urinary incontinence, bleeding, infection, and in rare cases, damage to the urinary tract that requires surgery. Additionally, you may experience burning or pain during intercourse after undergoing surgery due to stitches or scar tissue inside the vagina. [40] X Trusted Source Harvard Medical Schop Go to Source
- Depending on the specific case, you will be given local, regional, or general anesthesia. Many patients are able to leave the hospital one to three days after surgery, and most are able to return to their usual activities after about six weeks. [41] X Harvard Medical Schop Trusted Source Go to Source
- If you have uterine prolapse, your doctor may recommend a hysterectomy. If bladder prolapse is associated with pressure incontinence, your doctor may perform a parallel urethral suspension procedure.
Advice
- Although it can be painful, uncomfortable, and inconvenient, prolapse is curable and is not life-threatening. Don’t panic when you think you have a prolapsed bladder; You just need to go to the doctor and talk to your doctor about the right treatment. Then your condition will be in complete remission.
This article was co-written by Lacy Windham, MD. Dr. Windham is a Board Certified Obstetrician & Gynecologist in Tennessee. She attended medical school at the University of Tennessee Health Science Center in Memphis and completed her residency at East Virginia School of Medicine in 2010 for which she was awarded the Distinguished Residency in Obstetrics and Gynecology, Doctor of Obstetrics and Gynecology. Best Resident in Oncology and Best Resident Doctor.
There are 17 references cited in this article that you can view at the bottom of the page.
This article has been viewed 15,813 times.
A condition in which a woman’s bladder moves out of position and swoops down into the vagina is called “prolapsed bladder.” Anatomically, the bladder is located between the pubic bone (anterior) and the uterus (posterior) and above the vagina. Bladder prolapse, also known as bladder hernia, occurs when the vaginal wall muscles weaken and are not able to hold the pelvic organs in place. In this case, the bladder protrudes or retracts into the vagina. [1] X Trusted Source Mayo Clinic Go to Source About 11% of women need surgery to correct bladder prolapse. [2] X Source of Research Bladder prolapse can be uncomfortable and uncontrollable, so it’s important to diagnose and correct symptoms as quickly and effectively as possible. [3] X Cleveland Clinic Trusted Source Go to Source
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