Bladder Prolapse

It’s a little known fact that the walls of your vagina play an important role in supporting your bladder. So if the usually robust vaginal wall weakens or loosens, you can suffer a bladder prolapse.

This is when the bladder slips from its usual position and protrudes into the vagina. This is the most common form of prolapse.

Usually you’ll know if you’ve a bladder prolapse as you can feel it. Or perhaps your partner can during sex.

The symptoms include pressure in the vagina, almost as if a small ball were lodged inside. Or there may be swelling or a bulge at the opening of your vagina. Or you may feel like something is about to fall out of there!

For some women it can be a huge relief to find out that the ‘ball’ or bulge inside is merely a bladder prolapse, and not a tumour or something else equally as frightening.

Depending on the severity, bladder prolapse symptoms can also include:

  • Difficulty emptying your bladder

  • Physical discomfort

  • Light bladder leakage or stress incontinence which is urine leakage when you sneeze, cough, do physical exercise or lift a heavy object such as a toddler or a big bag of groceries

  • Problems having sex

  • Constipation

What causes bladder prolapse?

A bladder prolapse – or cystocele as doctors call it – usually happens as a result of a significant stress on the vaginal wall, such as the delivery of a baby. This is because during childbirth the vagina’s muscles endure intense pressure. The walls stretch and may even tear. The vagina is very good at repairing itself after childbirth, but it may never recover to its original strength. This means that its ability to hold up the bladder – especially if it’s full – is compromised.

Bladder prolapse can also happen after you hit middle-age as your body’s production of oestrogen – the female hormone that helps keep your vaginal walls toned and fit – falls sharply after menopause. Consequently, vaginal walls can sag, which in turn causes the bladder to fall from its rightful place.

Physical straining can also cause bladder prolapse. Lifting heavy objects, straining to perform bowel movements, having a long-term condition that causes coughing, or long-term constipation may damage the muscles supporting your bladder and so lead to bladder prolapse.

Of course, bladder prolapse doesn’t happen to every weightlifting, menopausal, constipated mother. But if it does happen to you, don’t panic – you’re not the only one and there are very effective treatments.

The four grades of bladder prolapse

These four 4 grades of bladder prolapse are based on how far the bladder droops into the vagina.

  • Grade 1 – mild prolapse: only a small portion of the bladder drops into the vagina.
  • Grade 2 – moderate prolapse: your bladder has dropped enough to reach the opening of the vagina.
  • Grade 3 – severe prolapse: your bladder actually protrudes outside of your vagina.
  • Grade 4 – complete prolapse: the entire bladder protrudes completely outside the vagina. This is usually associated with other forms of pelvic organ prolapse, such as uterine prolapse, bowel prolapse and vaginal prolapse.

Diagnosing bladder prolapse

If you suspect you have bladder prolapse, you should get to your doctor for a proper diagnosis. This is quite straightforward and won’t hurt a bit. Your doctor will examine your vagina and probably ask you to cough or push so your bladder’s position can be checked and evaluated.

Treating bladder prolapse

The good news is that bladder prolapse is reasonably easy to treat in mild or moderate cases. While with severe cases there are good chances of cure and complete recovery thanks to the very effective treatments and relatively simple surgeries available. Your doctor will be able to tell you more about the options.

Pelvic floor exercises

If you’ve a mild case of bladder prolapse, you may simply have to get to work on strengthening your pelvic floor with Kegel exercises. These pelvic floor exercises are designed to strengthen the vaginal walls so they can do their job of supporting the bladder in its proper position. Once your bladder is back in its rightful place, you should find you no longer leak urine or suffer stress incontinence.

Oestrogen therapy

If your bladder prolapse is associated with menopause, your doctor may suggest oestrogen therapy to improve your muscle tone. Vaginal lubricants can also help to reduce vaginal irritation caused by bladder prolapse in menopausal or post-menopausal women.

Pessaries

Your doctor may also suggest a pessary, which is a device inserted into the vagina to hold the bladder in its correct position. It sits high inside the vagina and you should not be able to feel it. After your doctor has installed the pessary, you can resume all of your normal day-to-day activities including sex and sports. In fact the pessary should help you be more active than ever as it supports the prolapse and should make you feel more comfortable.

Pessary devices can irritate the bladder and urethra in some people. But if you don’t experience any irritation, they can be an excellent way to treat bladder prolapse.

Surgery

Serious cases of bladder prolapse require surgery to reposition the bladder and restore its support. It’s performed under either a spinal anaesthetic (you’re awake in the top half of your body) or a general anaesethtic. The surgery itself is quite simple: the surgeon makes an incision in your vagina then places stitches in the tissue supporting the vagina.

These stitches may be at the front or the back walls of the vagina or both, depending on the type of prolapse you have. You’ll be allowed to go home once you are feeling well and you’re able to pass urine with no problem – usually within three to five days of the operation. In around 70% of cases, conventional surgery for bladder prolapse results in a successful outcome!

Managing light bladder leakage

It’s easy to keep yourself nice down there while you wait for treatment or for the pelvic floor exercises to take effect. Poise has a range of discreet products for managing light bladder leakage. Only you will know you’re using them, as they’re thin and discreet like any regular liner, but more absorbent so you’ll be covered.