Bladder prolapse symptoms include a feeling of pressure or fullness in the pelvic area and the feeling of something protruding from the vagina. With bladder prolapse, the bottom of the bladder sags due to weakening of the pelvic floor muscle. The most common cause of bladder prolapse or bladder prolapse is a difficult childbirth, which is very stressful on the tissue and muscles that support the bladder. A gynecological examination is performed to determine the nature and extent of the complaints. Depending on the nature and severity of the complaints, different types of treatments are possible for bladder prolapse. Treatment often consists of physiotherapy, medication, a diaphragm or surgery.
- What is a bladder prolapse?
- Cause of a prolapsed bladder
- A difficult birth
- Transition
- Long-term overload
- Become older
- Symptoms of bladder prolapse
- Phenomena
- Asymptomatic
- Bladder prolapse staging
- Examination and diagnosis
- Treatment of bladder prolapse
- Medical interventions
- Self-care measures
- Forecast and prospects
- Prevention
Location of the bladder in the body / Source: Decade3d/Shutterstock.com
What is a bladder prolapse?
The urinary bladder is a more or less spherical, hollow organ with an extensible wall, located in the pelvis. The bladder stores urine produced by the kidneys. The body has two kidneys and each kidney is connected to the bladder by a ureter. The bladder can hold an average of about 400 ml. contain urine, but empty the bladder is not much bigger than a billiard ball. The pressure created when the bladder fills with urine causes the urge to urinate. When someone urinates, urine flows from the bladder through the urethra.
Weakening of the pelvic floor muscle
One speaks of bladder prolapse when the floor of the bladder sags as a result of weakening of the pelvic floor muscle. This can happen, for example, after a difficult birth and is often accompanied by sagging of the anterior vaginal wall. With bladder prolapse, the front wall of the vagina, on which the bladder rests, sags outwards. This can cause all kinds of complaints, such as involuntary loss of urine and difficulty emptying the bladder. Bladder prolapse can range from mild to severe. A bladder prolapse is often accompanied by the sagging of the front wall of the vagina (vaginal prolapse). A prolapse of the bladder into the vagina is also called a ‘cystocele’.
Cause of a prolapsed bladder
The following factors may underlie bladder prolapse:
A difficult birth
This is the most common cause of a prolapsed bladder. A difficult birth is very stressful on the tissue and muscles that support the bladder.
Transition
The hormone estrogen contributes to keeping the pelvic floor muscles healthy and strong. After menopause, the body produces less estrogen and due to a reduced estrogen level there is a greater risk of bladder prolapse.
Long-term overload
Being overweight, lifting heavy objects, straining during bowel movements and chronic coughing due to smoking or a lung disease (for example COPD). This can weaken and damage the pelvic floor muscles.
Become older
As you get older, the pelvic floor muscles become weaker. That is why prolapse mainly occurs in people over the age of 50.
Bladder / Source: Designua/Shutterstock.com
Symptoms of bladder prolapse
Phenomena
The farces often arise at the end of a day with a lot of effort. Symptoms of a prolapsed bladder include:
- A feeling of pain and sagging in the vagina, which many women describe as the feeling of having a ball between the legs;
- Pain in the vagina, pelvic area (pelvic pain), lower abdomen, lower back, or groin;
- Heavy feeling or pressure in the vaginal area;
- Pain during sex (dyspareunia);
- Difficulty emptying the bladder;
- A strong urge to urinate;
- Frequent urination;
- The feeling that the bladder is not empty immediately after urination;
- Stress incontinence or effort incontinence: involuntary loss of urine during exertion, such as laughing, lifting, coughing or exercising, etc.
- More frequent bladder infections.
Asymptomatic
Some women with mild bladder prolapse experience little or no symptoms.
Bladder prolapse staging
The staging of a bladder prolapse is based on the severity of the prolapse.
| Stage | Description |
| Grade 1 (mild) | Only a small part of the bladder drops into the vagina. |
| Grade 2 (moderate) | The bladder drops so much that it can reach the opening of the vagina. |
| Grade 3 (severe) | The bladder pushes the front wall of the vagina outward when straining. |
| Grade 4 (complete) | The prolapse passes the entrance to the vagina without pressing; usually associated with other forms of prolapse (uterine prolapse, rectal prolapse, and small bowel prolapse). |
Examination and diagnosis
A gynecological examination is performed to determine the nature and extent of the complaints. If necessary, the doctor may suggest additional examinations, such as a urodynamic examination to test the function of the bladder and the closing mechanism of the bladder. A urodynamic is an internal examination in which thin tubes are inserted through the urethra and rectum. This allows measurements to be made of bladder contents, bladder pressure, bladder closure, urine loss (if present), urine outflow rate and tension in the pelvic floor muscles. The measurement results are registered in a computer. The examination usually takes half an hour to 45 minutes. In addition, a cystoscopy can be performed. This is a visual examination in which the doctor looks into the bladder through the urethra using a cystoscope. Research can also be done into the functioning of the pelvic floor muscles by a pelvic physiotherapist. Depending on the results of the examination, the physiotherapist may recommend special pelvic floor training.
Treatment of bladder prolapse
Medical interventions
Depending on the severity of the complaints, different types of treatment are possible for bladder prolapse:
- Physiotherapy. Exercises for the pelvic floor muscles can provide a solution for mild prolapse.
- Medicines. Hormone treatment can strengthen muscles and supporting tissues.
- A diaphragm (a plastic ring). This ring is inserted into the vagina and provides support. If this does not provide sufficient relief, surgery may provide a solution.
- An operation. In the event of prolapse of the front of the vagina, a bladder prolapseplasty can be performed, in which the front wall is moved into place.
Maintain a healthy weight to prevent bladder prolapse / Source: Istock.com/VladimirFLoyd
Self-care measures
There are a number of lifestyle recommendations that you can follow so that the prolapse does not worsen. These are:
- Try to prevent coughing by, for example, not smoking or treating COPD properly.
- Try to prevent obesity or try to lose weight if you are overweight and then maintain a healthy weight;
- Take your time on the toilet, don’t be in a hurry, just relax. This can prevent pelvic floor problems.
- Breathe well when you bend, bend or lift. So don’t hold your breath.
- Don’t lift heavy things.
- Sitting properly and moving in a relaxed manner is good for the back and pelvis.
Forecast and prospects
Long-term bladder prolapse is rarely a life-threatening condition. Most mild cases of bladder prolapse can be treated without surgery, and the most severe cases can be completely corrected with surgery.
Prevention
To prevent a prolapsed bladder, a high-fiber diet and daily intake of plenty of fluids can reduce the risk of constipation. Straining while defecating should be avoided if possible. Women with long-term constipation should seek medical attention to reduce the chance of developing a prolapsed bladder. Heavy lifting is associated with a prolapsed bladder and should be avoided if possible. Obesity is a risk factor for developing a prolapsed bladder. Weight management can help prevent this condition from developing.
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