Prolapse Of The Uterus
In prolapse of the uterus, the uterus drops down into the vagina. It usually results from weakening of the connective tissue and ligaments supporting the uterus. The uterus may bulge in the following ways:
Only into the upper part of the vagina
Down to the opening of the vagina
Partly through the opening
All the way through the opening, resulting in total uterine prolapse
How far down the uterus drops down determines how severe symptoms are.
At first, prolapse of the uterus may cause mild or no symptoms. When prolapses worsens, the first symptom most women report is feeling a bulge at the opening of the vagina. They may also have pain in the lower back or over the tailbone, difficulty having a bowel movement, and pain during sexual intercourse, as well as a feeling of heaviness or pressureâa feeling that pelvic organs are dropping out.
Total uterine prolapse can cause pain during walking. Sores may develop on the protruding cervix and cause bleeding, a discharge, and infection.
Constipation Constipation in Adults Constipation is difficult or infrequent bowel movements, hard stool, or a feeling that the rectum is not totally empty after a bowel movement . (See also Constipation… read more can occur.
What Causes Pelvic Organ Prolapse
Pelvic organ prolapse happens when the muscles or connective tissues of the pelvis do not work as they should. The most common risk factors are:
- Vaginal childbirth, which can stretch and strain the pelvic floor. Multiple vaginal childbirths raise your risk for pelvic organ prolapse later in life.4 But you can get prolapse even if you have never had children or if you had a cesarean, or C-section, delivery.
- Long-term pressure on your abdomen, including pressure from obesity, chronic coughing, or straining often during bowel movements
- Giving birth to a baby weighing more than 8½ pounds5
- Aging. Pelvic floor disorders are more common in older women. About 37% of women with pelvic floor disorders are 60 to 79 years of age, and about half are 80 or older.1
- Hormonal changes during menopause. Loss of the female hormone estrogen during and after menopause can raise your risk for pelvic organ prolapse. Researchers are not sure exactly why this happens.6
- Family history. Researchers are studying how genetics can play a role in pelvic organ prolapse.
My Bladder Has Fallen And I Cant Get Up Why Didnt Anyone Tell Me About Cystocele
When I was pregnant with my first child, I read everything I could. But, one thing no one told me was that one possible side effect of childbirth could be that my bladder may someday fall out of its normal resting spot inside my body.
Now before I send any of my pregnant readers into a tizzy, please note that this condition, known as cystocele, is fairly uncommon, especially among younger women. But, if you have ever needed a reason to kegel, keep reading.
OK. . .all clear?
Heres the scoop:
It was another ordinary night in the Fairly Odd household in spring 04. Fairly Odd Father was enjoying a night out with the boys to see the Boston Bruins. I was four months pregnant with my third child. Belly was three and Jilly had just turned a year old.
I decided to give the girls a bath, so I got the water in the tub ready. But, as I lifted them into the tub, I felt an odd sensation. It was if something was sliding out of me. Not painful, just not right. I had visions of me birthing my baby right then and there, on the bathroom floor. I thought about an ex-coworker who told the story of how her mother knew she was about to birth her twins when she looked down and saw a leg coming out. I hope I dont see a leg was all my brain could muster.
I then reached down and pushed something back up into my body. Something squishy and fleshy and not a baby leg. I suppose I should be so very thankful of that fact.
I answered his questions:
Really? Well, OK!
This was unbelievable to me.
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Can A Prolapse Be Prevented
There are several things you can do to reduce your risk of prolapse, including:
- doing regular pelvic floor exercises
- maintaining a healthy weight or losing weight if you’re overweight
- eating a high-fibre diet with plenty of fresh fruit, vegetables, and wholegrain bread and cereal to avoid constipation and straining when going to the toilet
- avoiding heavy lifting
If you smoke, stopping smoking may also help to reduce your risk of a prolapse.
How Do Health Care Professionals Treat A Cystocele
Your cystocele usually does not need treatment if you dont have symptoms.
If you have a cystocele with symptoms, your health care professional may recommend nonsurgical treatment or surgery, depending on the severity of the cystocele, your age, other health problems, sexual activity, desire for future children, and personal preferences.
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Who Is At Risk For Cystocele
People most at risk for cystocele-prolapsed bladder include:
- Women who have given birth vaginally
- Women in menopause, which weakens the pelvic floor as the body stops making estrogen
- Women who have had a hysterectomy
- Women who are genetically predisposed to having weaker connective tissues
- Women who are obese
Will My Uterus Fall Out
While your uterus and other organs will not fall out of your body, the weakening of your pelvic floor muscles can make it feel and appear as though this may happen. The most common and bothersome symptom is pressing of the uterus or other organs against the vaginal wall. The pressure on your vagina may cause minor discomfort or problems in how your pelvic organs work, and may cause discomfort during sex.
The symptoms of prolapse will vary based on the degree and the type of prolapse patients may suffer from one or more symptoms with varying severity, though many women who have pelvic organ prolapse do not have symptoms.
What Is Bladder Prolapse
When pelvic floor muscles weaken the bladder can prolapse out of its proper position. As women age, the front vaginal wall that supports the bladder can weaken or loosen. If weakened, the bladder can prolapse, meaning it is no longer supported and descends into the vagina. A prolapsed bladder can cause problems such as urinary difficulties, discomfort and stress incontinence.
The bladder is one of five pelvic organs susceptible to prolapse, called pelvic organ prolapse . About 40 percent of women experience POP. A complex structure of muscles, ligaments and skin holds the pelvic organs in place. Age, injury and childbirth are the most common reasons the pelvic organs prolapse.
Bladder prolapse cases are categorized into four grades according to the extent of the prolapse.
- Grade 1 : A small portion of the bladder drops into the vagina.
- Grade 2 : Part of the bladder falls as low as the opening of the vagina.
- Grade 3 : The bladder sticks out through the vaginal opening.
- Grade 4 : The whole bladder protrudes outside the vagina this often occurs along with prolapse of other pelvic organs.
What Causes Vaginal Prolapse
There are no direct causes of vaginal prolapse. However, women are at an increased risk of developing vaginal prolapse if they:
- Delivered children vaginally, especially repeat deliveries
- Are approaching or experiencing menopause
- Have certain lifestyle factors, including being overweight
- Were born with a rare condition, such as bladder exstrophy
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Demystifying Pelvic Organ Prolapse
Reproductive and urologic health can be a cause for concern for many people. Often, the topic of pelvic organ prolapses is not discussed until a patient has already experienced symptoms. As a urogynecologist, an important part of my role is to help patients understand what pelvic prolapses are and what can be done to treat them.
What Is Pelvic Organ Prolapse Do I Have It
As women age, the changes that can happen to her body are too vast to count. Just when you think you are past the point of bleeding and pain each month, you realize you arent done with gynecological challenges just yet. Aging brings menopause, increased risks of GYN cancers, and the possibility that your uterus, bladder or rectum will start to sag into your vagina.
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Causes Of A Prolapsed Bladder
The following factors are commonly associated with causing a prolapsed bladder:
- 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 womanâs bladder.
- 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.
When To Seek Help
If you are concerned you may have a prolapsed bladder and are experiencing troublesome symptoms, see your doctor. You can also visit a physiotherapist who is trained to help you with pelvic floor exercises. If you are experiencing urinary incontinence associated with a prolapse, a continence nurse adviser may help.
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What Other Therapies Treat A Prolapsed Bladder
Physical therapy such as electrical stimulation and biofeedback may be used to help identify and strengthen the muscles in the pelvis, particularly in those individuals who fail to respond to pelvic floor muscle exercises on their own.
- Electrical stimulation: A doctor can apply a probe to targeted muscles within the vagina or on the pelvic floor. The probe is attached to a device that measures and delivers small electrical currents that contract the muscles. These contractions help strengthen the muscles. A less intrusive type of electrical stimulation is available that magnetically stimulates the pudendal nerve from outside the body. This activates the muscles of the pelvic floor and may help treat incontinence.
- Biofeedback: A sensor is used to monitor muscle activity in the vagina and on the pelvic floor. The doctor can recommend exercises that can strengthen these muscles. These exercises may help strengthen the muscles to reverse or relieve some symptoms related to a prolapsed bladder. The sensor can monitor the muscular contractions during the exercises, and the doctor may be able to determine if the targeted muscles would benefit from the exercises.
Diagnosis Of Bladder Prolapse
Bladder prolapse is diagnosed by:
- medical history including checking for possible risk factors
- physical vaginal examination to allow assessment of the degree of prolapse, pelvic floor muscle function, presence of any other prolapse and other abnormalities in the pelvis, such as tumours or masses.
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Recognizing The Symptoms Of Bladder Prolapse
One of the first and most notable signs of prolapse is a feeling like theres a ball of tissue in the vagina.
There are several symptoms related to pain including:
- Low back pain
- Pain or discomfort in the pelvic area
- Pain during sex
Symptoms relating to urinary function include:
- A sense of a ball of tissue inside the vagina or the sensation that something is falling out of the vagina
- Difficulty urinating or with bowel movements
- Urinary incontinence
- Incomplete voiding
Painful or bleeding tissue protruding is one of the most obvious signs. However, women suffering from a very mild uterine prolapse or early-stage uterine prolapse may experience few, if any, symptoms.
Who Is At Risk To Experience A Pelvic Prolapse And How Common Are They
Pelvic organ prolapse occurs as a result of weakening of the pelvic support structures. This is a result of a combination of childbirth injury, genetics, aging and chronic straining with constipation. It is very common, with about 50 percent of women having some degree of prolapse. Over 12 percent of American women will have surgery for it in their lifetime.
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How Is Pelvic Organ Prolapse Diagnosed
Your doctor will talk to you about your symptoms and do a pelvic exam. You may be asked to strain or cough during the exam so your doctor can see whether these actions cause prolapse or urine leakage. Your doctor may also do other tests to see whether you can completely empty your bladder when you go to the bathroom.
What Are The Different Types Of Pelvic Organ Prolapse
The different types of pelvic organ prolapse depend on the pelvic organ affected. The most common types include:
- Dropped bladder . This is the most common type of pelvic organ prolapse. This happens when the bladder drops into or out of the vagina.
- Rectocele. This happens when the rectum bulges into or out of the vagina.
- Dropped uterus . This happens when the uterus bulges into or out of the vagina. Uterine prolapse is sometimes associated with small bowel prolapse , where part of the small intestine, or small bowel, bulges into the vagina.
Although it is rare, pelvic organ prolapse can also happen after a hysterectomy. Any part of the vaginal wall may drop, causing a bulge into or out of the vagina.
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Treating Pelvic Organ Prolapse
There are several treatment options available for a pelvic organ prolapse, depending on your circumstances.
The treatment most suitable for you depends on:
- the severity of your symptoms
- the severity of the prolapse
- your age and health
- whether you’re planning to have children in the future
You may not need any treatment if your prolapse is mild to moderate and not causing any pain or discomfort.
The various treatments for pelvic organ prolapse are outlined below.
What Is A Dropped Bladder
A dropped bladder, also known as a prolapsed bladder, occurs when the wall between a woman’s vagina and bladder weaken and the bladder drops into the vagina. The medical term for this condition is called cystocele. This condition often occurs after childbirth when the vagina heals but never recovers its full strength. It can also occur as a result of menopause when estrogen levels decrease. This reduction in estrogen weakens the vaginal walls.
Lifting heavy objects can also cause strain to the muscles surrounding the bladder and vagina. Frequent straining during bowel movements has also been known to cause a prolapsed bladder. No matter how the dropped bladder occurs, this weakening of the vaginal walls causes the bladder to slip so that it rests outside of the abdomen.
Women who suffer from a dropped bladder condition may experience urine leakage whenever they laugh, cough, and perform other activities that cause the abdomen to press on the bladder. The pressure of the abdomen on the abdomen causes urine leakage. This condition is uncomfortable that causes a woman to feel pressure inside the vagina, almost as if a small ball is resting inside the birth canal. Any bladder tissue exposed through the vaginal opening may feel painful and tender.
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Why Does Prolapse Happen
Prolapse is caused by weakening of tissues that support the pelvic organs. Although there’s rarely a single cause, the risk of developing pelvic organ prolapse can be increased by:
- your age prolapse is more common as you get older
- childbirth, particularly if you had a long or difficult labour, or gave birth to multiple babies or a large baby up to half of all women who have had children are affected by some degree of prolapse
- changes caused by the menopause such as weakening of tissue and low levels of the hormone oestrogen
- being overweight, obese or having large fibroids or pelvic cysts which creates extra pressure in the pelvic area
- previous pelvic surgery such as a hysterectomy or bladder repair
- repeated heavy lifting and manual work
- long-term coughing or sneezing for example, if you smoke, have a lung condition or allergy
- excessive straining when going to the toilet because of long-term constipation
Certain conditions can also cause the tissues in your body to become weak, making a prolapse more likely, including:
- joint hypermobility syndrome where your joints are very loose
- an inherited condition that affects the blood vessels, eyes and skeleton
- Ehlers-Danlos syndrome a group of inherited conditions that affect collagen proteins in the body
Stages Of Bladder Prolapse
The severity of bladder prolapse can be measured in several ways. Terms such as mild, moderate and severe are not always completely accurate, as they depend on a persons opinion, but are often used in day-to-day conversations to help people understand the severity of the prolapse.A more commonly used grading is:
- Stage 1 the bladder protrudes a little way into the vagina
- Stage 2 the bladder protrudes so far into the vagina that its close to the vaginal opening
- Stage 3 the bladder protrudes out of the vagina
- Stage 4 most severe form, in which all pelvic organs including the bladder protrude out of the vagina.
Many gynaecologists now use the Pelvic Organ Prolapse Quantification system, which measures in centimetres where the prolapse is in relation to the vaginal entrance to ascertain the stage of prolapse.
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