Causes Of Bladder Prolapse In Women
Significant bodily stress from childbirth is the most common cause of bladder prolapse. When a baby is delivered, the process damages vaginal tissues and muscles, which support a womans bladder.
Bladder prolapse frequently occurs with menopause, when womens bodies begin to produce less estrogen. The hormone estrogen strengthens muscles of and around the vagina, so when estrogen decreases with menopause, those muscles often weaken.
Any type of heavy straining such as lifting heavy objects, straining during bowel movements or long-term constipation can also damage important pelvic floor muscles, causing bladder prolapse.
Complication Rates By Type Of Sling
Before undergoing bladder sling surgery, women should ask their doctors about the technique they plan to use. Complication rates may vary depending on the type of mesh sling and technique.
A 2010 study of bladder sling procedures by Z. Chen and colleagues published in Urologia analyzed the outcomes of 187 women who received bladder slings to treat stress urinary incontinence. Authors found that transobturator vaginal tape inside-out and transobturator vaginal tape out-inside are simpler techniques with fewer complications compared to tension-free vaginal tape .
Women who used TVT had an average hospital stay of five days versus about two days for the TOT group.
The complication rate in the study was:
- 15.6 percent for tension-free vaginal tape
- 9.20 percent for transobturator vaginal tape inside-out
- 8.90 percent for transobturator vaginal tape out-inside
Complications from the procedures included discomfort with urinating, bleeding outside blood vessels and dysfunction of lower limbs. TVT was the only procedure associated with bladder perforation. Despite the complication rate, doctors found the slings safe.
The three tension-free urethral suspension techniques have similar efficacy, all of them are safe and effective procedures for the treatment of female SUI, authors wrote.
Bladder Sling Complications And Interstitial Cystitis
Some symptoms of bladder sling complications are similar to those of interstitial cystitis , a painful bladder condition that affects millions of Americans. More women than men are likely to get the disease.
Common signs of IC that may overlap with bladder sling complications include: Pelvic and bladder pain, painful sexual intercourse and urinary urgency.
While treating urinary incontinence may involve implanting a mesh bladder sling, doctors typically treat IC with medications instead of surgery. But these medications have their own side effects.
Elmiron is the only FDA-approved oral medication to treat the pain and discomfort of IC in the United States. Some recent studies have linked Elmiron to a degenerative vision condition called pigmentary maculopathy.
Read Also: What Can Happen If A Bladder Infection Goes Untreated
How To Diagnose And Treat A Prolapsed Bladder
This article was medically reviewed 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 the Eastern Virginia Medical School in 2010, where she was awarded the Most Outstanding Resident in Maternal Fetal Medicine, Most Outstanding Resident in Oncology, and Most Outstanding Resident Overall.There are 12 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. In this case, 96% of readers who voted found the article helpful, earning it our reader-approved status. This article has been viewed 112,458 times.
Experts say that your bladder may fall from it’s normal position in your pelvis if your pelvic floor becomes too weak or there’s too much pressure on it.XTrustworthy SourceMayo ClinicEducational website from one of the world’s leading hospitalsGo to source When this happens, your bladder presses on your vaginal wall, which is called a prolapsed bladder. Research suggests that as many as 50% of women have some form of bladder prolapse after pregnancy, so it’s a fairly common problem.XTrustworthy SourceHarvard Medical SchoolHarvard Medical School’s Educational Site for the PublicGo to source If you’re worried you have a prolapsed bladder, talk to your doctor because you have a range of treatment options.
What Causes A Prolapsed Bladder
Factors commonly associated with causing a prolapsed bladder are those that weaken the pelvic floor muscles and ligaments that support the bladder, urethra, uterus, and rectum, which can lead to detachment from the ligaments or pelvic bone where the muscles attach:
- Pregnancy and childbirth: This is the most common cause of a prolapsed bladder. The delivery process is stressful on the vaginal tissues and muscles, which support a woman’s bladder.
- Aging can lead to weakening of the muscles.
- Menopause: Estrogen, a hormone that helps maintain the strength and health of supporting tissues in the vagina, is not produced after menopause.
- Previous pelvic surgery: such as hysterectomy
- Other risk factors that increase the pressure within the abdomen, leading to increased pressure on the pelvic floor muscles include chronic obstructive pulmonary disease , obesity, constipation, and heavy manual labor .
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Vaginal Extrusion And Erosion
One of the main concerns with bladder slings has been mesh extrusion or erosion. Extrusion and erosion both refer to mesh forcing its way into the vagina, bladder, urethra or other organ. In these cases, the mesh wears through the tissues.
According to a paper by Dr. Cristiano Mendes Gomes and colleagues, vaginal extrusion rates vary from 0 percent to 1.5 percent for retropubic slings, which are inserted through an incision in the vagina and positioned in a U shape around the urethra. The ends of retropubic slings are maneuvered between the bladder and pubic bone and brought out through incisions above the pubic bone.
For transobturator slings, the vaginal extrusion rates vary from 0 percent to 10.9 percent, according to the paper published in Internal Brazilian Journal of Urology. Known as TOT, this procedure avoids the space between the pubic bone and the bladder. Mesh is inserted through the vagina and the ends are brought out through incisions between the labia and the creases of the thighs.
Additionally, Gomes and colleagues found urethral erosion happened after less than 1 percent of sling surgeries.
Three months postoperatively, she stated that her husband felt teeth in her vagina during sexual intercourse, Siegel wrote.
A pelvic exam revealed mesh extrusion.
In some cases, conservative management of erosion may be possible. For example, some surgeons may prescribe topical estrogen cream to help vaginal tissues heal.
What Is A Prolapsed Bladder
Pelvic organ prolapse is a surprisingly common condition. In fact, its estimated that about half of women over 50 have some level of prolapse. The pelvic floor is a web of muscles and tissues that supports your pelvic organs, including the bladder, bowel, and uterus. When these muscles and tissues become weakened or damaged, one or more of these pelvic organs can drop or collapse, causing uncomfortable symptoms.
While any of the organs listed above can drop, the most common type of prolapse is a dropped bladder, also known as a cystocele.
There are different levels of a prolapsed bladder, which are measured on a grade from 1-3 with 1 being the mildest, and grade 3 being the most severe. The grade of prolapse is measured by how far the bladder has fallen into the vagina. A grade 1 cystocele is when the bladder has dropped only slightly. A grade 2 cystocele is when the bladder has dropped to the opening of the vagina. A prolapsed bladder is classified as a grade 3 when the bladder has fallen so far that it bulges out of the vagina.
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Bladder Prolapse At A Glance
- Bladder prolapse occurs when the hammock of pelvic floor muscles that support the bladder weakens and the bladder drops out of its proper position.
- Bladder prolapse, also called cystocele, commonly occurs in women due to age, injury or childbirth.
- The main symptom of BP is tissue protruding in the vagina, which women describe as a feeling like a ball.
- BP is categorized on a scale of 1 to 4, based on how far the bladder drops into the vagina.
- Treatment ranges from lifestyle changes to medications and surgery.
Where Can Someone Get More Information On Prolapsed Bladders
- Urologic conditions that can occur around the time a woman goes through menopause include
- bladder control problems,
- bladder prolapse , and
- urinary tract infections.
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Somethings Not Right Down There
Discovering your organs are out of place can be alarming! Most women notice a bulge of tissue protruding from their vagina when theyre showering or using the toilet, explains Tracy Cannon-Smith, M.D., a Urology Partners surgeon certified in female pelvic medicine and reconstructive surgery. In some cases, a woman may have to push the bulge in vaginally to urinate or have a bowel movement. Other women say they feel like theyre sitting on a ball.
There are other signs, too. Vaginal pain, bleeding, spotting or feeling like you have pulled a groin muscle are all symptoms of POP. Experts estimate that nearly 50 percent of all women will struggle with pelvic organ prolapse at some point during their lifetime. For a woman who is still sexually active, prolapse can be embarrassing and prevent intimacy with her partner, Dr. Cannon-Smith adds. Fortunately, there are several ways to fix prolapsevaginally and robotically.
Many Women Are Living With Uncomfortable Pelvic Organ Prolapse Here Are Your Next Steps If You’re One Of Them
One of the most uncomfortableand awkwardconditions that afflicts women is pelvic organ prolapse. Normally, the pelvic organsthe bladder, uterus, vagina, and rectumare supported and held in place by a group of muscles and tissues called the pelvic floor. When these muscles weaken over time, the pelvic organs can droop down and bulge out of the vagina.
In addition to the sensation of feeling an uncomfortable bulge in the vagina, you can experience symptoms such as
- pain or pressure in the pelvis, the lower back, or both
- urinary problems, like urine leaking or the feeling that you need to constantly urinate
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The Best Treatment For Prolapsed Bladder
Are you suffering from a prolapsed bladder? If so, Renew Wellness & Aesthetics can help you determine the best treatment for you. In addition, we offer a variety of sexual wellness services for both men and women.
If you have any questions for us, call 405-810-5944 or schedule a consultation online. We look forward to helping you get rejuvenated and feel your best!
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Anterior Vaginal Wall Prolapse
Anterior vaginal wall prolapse often occurs at the top of the vagina where the uterus used to be in women who have had a hysterectomy. This type of prolapse occurs when the bladder’s supportive tissue, called fascia, stretch or detach from the attachments securing it to the pelvic bones. With this loss of support, the bladder falls down into the vagina. As this condition worsens, the prolapsed pelvic organs may bulge outside the opening of the vagina causing pressure, discomfort or pain. Other symptoms MAY include:
- Urinary frequency, nighttime voiding, loss of bladder control and recurrent bladder infectionsusually due to the bladder not emptying well
- Stress urinary incontinence with activity such as laughing, coughing, sneezing, or exercise) cause by weakened support for the urethra
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How Is A Cystocele Treated
If it is not bothersome, a mild cystocele may not require any treatment other than avoiding heavy lifting or straining that could cause the problem to get worse.
Other potential treatment options include the following:
- Weight loss.
- Estrogen replacement therapy.
- Kegel exercises to strengthen the openings of the urethra, vagina and rectum. These exercises involve tightening the muscles that are used to stop the flow of urine, holding for 10 seconds, and then releasing.
- If symptoms are modest, a device called a pessary may be placed in the vagina to hold the bladder in place. Pessaries are available in a number of shapes and sizes to ensure a proper fit. A pessary has to be removed and cleaned on a regular basis in order to avoid infection or ulcers.
Prolapsed Bladder Care At Home
For mild-to-moderate cases of prolapsed bladder, the doctor may recommend activity modification such as avoiding heavy lifting or straining. The doctor may also recommend Kegel exercises. These are exercises used to tighten the muscles of the pelvic floor. Kegel exercises might be used to treat mild-to-moderate prolapses or to supplement other treatments for prolapses that are more serious.
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What Are Treatments For A Prolapsed Bladder
Nonsurgical Treatment
Nonsurgical treatment consists of conservative management and the use of mechanical devices.
Behavioral therapy and pelvic floor muscle exercise are conservative therapies for management of bladder prolapse. The goal of conservative treatment is the reduction of symptoms, prevention of worsening pelvic organ prolapse, increased support of the pelvic floor musculature, and avoiding or delaying surgery. Behavioral therapy includes reducing risk factors such as treating constipation, weight loss if obese, and discontinuing smoking if COPD/cough, etc. PFME are muscle exercises to strengthen the pelvic floor muscles. The contractions should be held for two to 10 seconds and should be performed regularly several times per day. A set of 10 sustained contractions for a duration of about 20 minutes should be performed two to three times per day. This form of therapy is suitable for mild to moderate pelvic organ prolapse.
Treatment Options For A Prolapsed Bladder
There are many treatment options for a prolapsed bladder. One of the most common forms of treatment, and one that many people opt for first, is physical therapy. The pelvic floor is a muscle, and just like other muscles in the body, it can be strengthened with the appropriate exercises.
A physical therapist who specializes in pelvic floor therapy can work with you to determine the extent of your prolapse, gauge the strength of your pelvic floor muscles, and set you up on a routine to ensure the pelvic floor is working as it should.
Another option for treatment is a pessary. A pessary is a small disc-shaped device that is inserted into the vagina and helps to hold things up, relieving some of the pressure and other symptoms of prolapse. A pessary may be used in conjunction with physical therapy and may be ideal for those who experience symptoms during specific activities, such as when working.
If you have a prolapsed bladder, know that you can still live a very full and active life, doing many of the same things you did prior to having a prolapse. Talk to your doctor about treatment options. A pelvic floor physical therapist is a good first step and can help you try to strengthen your muscles naturally. Beyond that, a urogynecologist is a good option for more advanced treatments.
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How Can You Tell If Your Bladder Has Dropped
The urinary bladder is a hollow organ in the pelvis that stores urine. During urination, urine leaves the bladder and exits the body through the urethra. The vagina supports the front of the bladder in women. This wall can weaken with age or get damaged during vaginal childbirth. If weakness is significant, the bladder can prolapse , and this is called bladder prolapse or cystocele.
Many patients may be asymptomatic in the early stages. Signs and symptoms of a prolapsed bladder depend on the extent and grade of prolapse. Patients can usually tell if their bladder has dropped when they face difficulty urinating, pain or discomfort, and stressincontinence , which are the most common symptoms of a prolapsed bladder. One of the early symptoms of a prolapsed bladder is the presence of tissue that feels like a ball in the vagina. Some common signs and symptoms of a prolapsed bladder include:
Exams And Tests For A Prolapsed Bladder
An exam of the female genitalia and pelvis, known as a pelvic exam, is required in order to diagnose a prolapsed bladder. A bladder that has entered the vagina confirms the diagnosis.
For less obvious cases, the doctor may use a voiding cystourethrogram to help with the diagnosis. A voiding cystourethrogram is a series of X-rays that are taken during urination. These help the doctor determine the shape of the bladder and the cause of urinary difficulty. The doctor may also test or take X-rays of different parts of the abdomen to rule out other possible causes of discomfort or urinary difficulty.
After diagnosis, the doctor may test the nerves, muscles, and the intensity of the urine stream to help decide what type of treatment is appropriate.
A test called urodynamics or video urodynamics may be performed at the doctor’s discretion. These tests are sometimes referred to as “EKGs of the bladder”. Urodynamics measures pressure and volume relationships in the bladder and may be crucial in the decision making of the urologist.
Cystoscopy may also be performed to identify treatment options. This test is an outpatient office procedure that is sometimes performed on a television screen so the person can see what the urologist sees. Cystoscopy has little risk and is tolerable for the vast majority of people.
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Surgery For A Pelvic Organ Prolapse
If you have severe bladder prolapse, surgery may be required. During surgery, a mesh support is inserted into the vaginal wall and the bladderâs position is corrected. This can be performed under general, regional or local anesthesia. Talk with your doctor for more information on surgery options and if it is required to fix your prolapsed bladder.