A common but not always talked about condition that up to 11 percent of women will experience is bladder prolapse.  Many women who have this condition may not even realize what has happened but may express “I have low back pain,” or “It feels like I’m sitting on a ball,” or “It’s difficult for me to urinate.” 

In normal conditions, the bladder in women is held in place by a “hammock” of supportive pelvic floor muscles and tissue.  If these muscles and tissue are stretched or become weak, the bladder can drop down bulging through this layer and into the vagina.  When this happens it is termed as bladder prolapse or cystocele.  If the bladder sags far enough down it can actually either appear at the opening of the vagina or even protrude through the vaginal opening. 

As bad as bladder prolapse may sound, it is treatable.

Symptoms of bladder prolapse

Women who have bladder prolapse will most commonly have a feeling of a bulge in the vaginal area.  There can be women who may not experience any symptoms of bladder prolapse. 

Common signs and symptoms indicating bladder prolapse could include:

·Urinary incontinence

·Not feeling like you have completely emptied the bladder after urinating

·Having to frequently urinate or have the urge to pass urine

·Frequent urinary tract infections

·Pain in the vagina, pelvis, lower abdomen, groin, or lower back

·Painful sex

·A feeling of heaviness or pressure in the vaginal area

·Tissue sticking out of the vagina that may be tender and/or bleeding

Causes of bladder prolapse

There can be a number of different reasons for bladder prolapse.  Women are prone to bladder prolapse primarily because of pregnancy and having a vaginal delivery, both of which place major stress on the supportive “hammock” of the bladder.

Other causes of bladder prolapse can include:

·Heavy lifting

·Aging

·Constipation or frequent straining to pass a bowel movement

·Chronic coughing

·Obesity

·Menopause when estrogen levels begin to drop

·Prior pelvic surgery

Diagnosing bladder prolapse

Any woman experiencing the signs and symptoms of bladder prolapse needs to get an accurate diagnosis with her physician.  Once a detailed clinical history is taken, a thorough pelvic exam will be done to assess how serious the prolapse is.

There may be other tests and imaging studies done to check on the condition of the pelvic floor which could include a cystoscopy, urodynamics, x-rays, an ultrasound, and an MRI. 

Treating bladder prolapse

Treatment for bladder prolapse will depend on how extensive the problem is. If a woman is not having any bothersome symptoms and is not blocking urine flow, then treatment may not be necessary. 

However, if may still be advisable for any woman with bladder prolapse to do behavioral therapy which can include Kegel exercise to strengthen the pelvic floor muscles, pelvic floor physical therapy, using a vaginal support device called a pessary or trying estrogen replacement therapy.

Surgery is another option for bladder prolapse if more invasive needs are required.  The surgery can be done vaginally or laparoscopically through the abdomen.  Be sure to discuss with the surgeon before the surgery about the risks, benefits, and other options for repairing bladder prolapse. 

There is always the possibility of risk of bladder prolapse is not treated.  It is possible it could stay the same or it could slowly get worse.  In rare situations, severe bladder prolapse can obstruct the kidneys leading to kidney infection or damage and could also lead to urinary retention which the inability to pass urine.