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Urology

Urological Disorders

Prolapsed Bladder

What Is Prolapsed Bladder?


The bladder, located in the pelvis, is a hollow, muscular, balloon shaped organ that stores urine. The kidneys make urine when they filter the blood. Urine flows from the kidneys through a pair of thin tubes, the ureters, to the bladder, where it is stored until a person urinates. During urination, the urine leaves the body by passing from the bladder through another tube, the urethra.

A prolapsed bladder, also known as a dropped bladder or cystocele (SIS-tuh-seal), is a female urological condition. It occurs when the wall between a woman's bladder and her vagina weakens and stretches and lets the bladder droop into the vagina. This can cause discomfort, problems emptying the bladder, and stress incontinence (urine leakage when you cough, sneeze or laugh).

Symptoms

The main symptoms of prolapsed bladder include:

  • Abdominal pain or discomfort
  • Problems emptying the bladder
  • Stress incontinence
  • A bulge or swelling in the front wall of the vagina that may protrude through the vaginal opening, especially after lifting
  • Bladder infections

Causes

Common causes of a prolapsed bladder are:

  • Straining the pelvic floor muscles due to childbirth, heavy lifting, or straining during bowel movements
  • Menopause: the hormone estrogen helps keep the muscles around the vagina strong; after menopause, the body stops making estrogen, so the muscles around the vagina and bladder may grow weak.


Diagnosis

Diagnosis of prolapsed bladder or cystocele usually involves physical examination of the pelvis and vagina. Sometimes the fallen part of the bladder is visible during an exam. Another diagnostic test, a voiding cystourethrogram (sis-toe-yoo-REETH-roe-gram), takes x-rays of the bladder during urination. The x-rays show the shape of the bladder and any problems that might block the normal flow of urine. Other tests may be needed to find or rule out problems in other parts of the urinary system.

Evaluation

Prolapsed bladders (cystoceles) are graded by how far they droop into the vagina:

  • Grade 1(mild); the bladder droops only a short way into the vagina
  • Grade 2 (more severe): the bladder has sunk into the vagina far enough to reach the vagina’s opening
  • Grade 3 (most severe): the bladder bulges out through the opening of the vagina


Treatment Options

Treatment options for prolapsed bladder include:

  • No treatment is usually prescribed for a mild prolapsed bladder that causes no discomfort; you may be told to avoid heavy lifting and other strains that could worsen the condition.
  • Wearing a pessary, a device placed in the vagina to hold the bladder in place. Pessaries must be removed regularly to avoid infection or ulcers.
  • In the most sever cases, surgery may be needed to move the bladder back into a more normal position and keep it there. The hospital stay is usually several days, followed by a patient 4 to 6 week recovery period.
  • Estrogen replacement therapy (ERT) may be recommended for postmenopausal women to help strengthen the muscles around the vagina and bladder. It may be used alone or with the other forms of treatment.