The female reproductive organs — and the surrounding organs and structures — are kept in place by muscle and fascia, forming a thin fibrous sheet. If the muscles give way and weaken, the fascia is there to catch shifting organs. But fascia isn’t strong enough to be a weight-bearing support, and under pressure, it can quickly break down.
So when the muscles and tissue that separate your vaginal vault from your bladder break down, the fascia can’t provide enough support, and your bladder “drops.” A prolapsed bladder, also known as a dropped bladder for obvious reasons, can interfere with sexual intercourse and with day to day life. In severe cases, your bladder can drop into the opening of your vagina.
One form of bladder prolapse is called cystocele or anterior prolapse. Regardless what you call it or how bad your symptoms are, bladder prolapse is a treatable condition. The treatment usually involves surgery, but most women respond well to the procedure.
Bladder prolapse should always be evaluated with a thorough consultation and examination by your gynecologist for an accurate diagnosis and treatment plan to exclude any underlying serious condition.
How Do You Know It’s Bladder Prolapse?
If your bladder has only dropped a little, you may not notice any symptoms. You may not even suspect anything until your next pelvic examination, when your gynecologist mentions that your bladder has dropped a little. Like all conditions, bladder prolapse is a good thing to catch early.
On the other hand, if your condition is more advanced, symptoms may begin to demand attention. Some of the bladder problems you may notice include:
- Pressure on your bladder that may make you feel an urgency to urinate
- A sense that you can’t fully empty your bladder when you do urinate
- More frequent infections in your bladder
- A full feeling in your vagina
- Pain during intercourse
- Urine leaking during intercourse and at other times
- Problems trying to insert a tampon or applicator
- Symptoms pronounced when standing for a while
Furthermore, your pelvic area feels uncomfortable with strain and coughing. In other words, when you cough, you can feel it in your pelvic region. In severe cases, you may feel something bulging at your vaginal opening. When you sit, it feels like you’re sitting on something.
Regardless, all symptoms should always be evaluated with a thorough consultation and examination by your gynecologist for an accurate diagnosis and treatment plan to exclude any underlying serious condition.
In Danger of a Prolapsed Bladder
While mostly older women get bladder prolapse, it can affect women of any age. The reason it hits older women harder is due to the lack of estrogen after menopause. Estrogen keeps the female reproductive system strong; without it, muscles and tissues weaken. You may be at increased risk for bladder prolapse if:
- You’ve had one or more children through a vaginal delivery.
- You’ve had a hysterectomy. You’re more likely to have a bladder prolapse after hysterectomy.
- You are obese or overweight.
- You have family members — like your mother, aunt or sister — who suffered a dropped bladder.
- You are a smoker or have lung disease.
The Causes of Bladder Prolapse
When the muscles and tissues holding your bladder in place weaken or get stretched out, the fascia can’t handle the pressure, and your bladder drops. The reasons for this condition include:
- Trauma to those muscles and tissues
- Carrying multiple babies to term
- Straining during vaginal childbirth
- Constant exertion of your pelvic muscles
- Forcing your bowel movements from chronic constipation
- Constant heavy coughing
- Heavy lifting over time
Diagnosing a Dropped Bladder
The first step in diagnosing bladder prolapse is visiting your OBGYN. Explain your symptoms and answer your doctor’s questions. You’ll likely have a pelvic exam, too. By taking a medical history, pinpointing your symptoms and performing an exam, your gynecologist can narrow down the diagnosis. But to confirm the diagnosis of a prolapsed bladder, you’ll most likely get a bladder and urine test:
- The bladder test measures how fully you can empty your bladder. Your doctor may use ultrasound to see how well your bladder empties and how much urine it retains.
- The urine test can confirm if you have a bladder infection.
It’s vital that your OBGYN reaches an accurate diagnosis before starting you on any treatment. If you do have a prolapsed bladder, then your doctor can take the specific, effective measures to treat you.
Bladder Prolapse Treatments
For mild cases, you may not have to do anything more than begin doing Kegel exercises to strengthen your vaginal muscles. While it may not correct the problem; it sometimes keeps it from getting any worse. If you have a case that needs attention, there are several non-surgical options:
- If you’re postmenopausal, you can take the hormone estrogen — either as a pill, in a vaginal cream or from a hormonal vaginal ring. This therapy can strengthen your pelvic muscles and reproductive tissues.
- You can use a device called a pessary — a rubber device that’s inserted into your vagina to provide physical support to your vaginal walls. Although it can act as a temporary solution, women for whom surgery isn’t an option depend on a pessary.
If your case is severe enough, you may need a surgical solution. Depending on your situation — whether just your bladder has prolapsed, how far into your vaginal cavity it’s fallen, whether or not you still have your uterus, for example — you and your gynecologist can make an assessment. Choosing bladder prolapse surgery should not be undertaken lightly. While it’s a minor surgery, it’s still a surgery and has risks associated with it. Some surgical options include:
In each of these procedures, you’re given either general anesthetia or sedation so you’re unconscious. Commonly, a surgical approach is made through your vagina. Your doctor repositions your bladder back to its proper place. Then your muscles are tightened surgically and your ligaments are used to support the strengthened vaginal wall.
Your prolapsed bladder surgery recovery may take six full weeks, during which you’ll gradually heal. You won’t be able to have sex or use tampons during this recovery period, but you’ll be able to return to work as soon as a week after your procedure. The real danger is that if you’re still young, you’re at a greater risk to have another prolapsed bladder in the future. Talk to your OBGYN about your case.
Symptoms should always be evaluated with a thorough consultation and examination by your gynecologist for an accurate diagnosis and treatment plan to exclude any underlying serious condition.
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult ob/gyn doctor about your specific condition. Only a trained, experienced board certified gynecologist can determine an accurate diagnosis and proper treatment.
Do you have questions about Bladder Prolapse? Would like to schedule an appointment with NYC leading Gynecologist, Dr. Anat Zelmanovich, please contact our office.
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Midtown OB/GYN)
New York, NY 10010
☎ (212) 533-4575
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Upper East Side OB/GYN)
New York, NY 10028
☎ (212) 533-4575