Overview
A bladder prolapse cystocele, also known as a dropped bladder, occurs when a woman’s bladder drops from its normal positioning within the pelvis. This causes the bladder to push on the wall of the vagina, creating pressure and discomfort.
Normally, the bladder, uterus, and intestines are held in place by connective tissues and muscles on the pelvic floor. Sometimes, the pelvic floor endures too much pressure or becomes weak. This causes a bladder prolapse cystocele.
There are many potential causes for a bladder prolapse. The most common causes are childbirth and pregnancy. Additional causes include chronic coughing, lifting heavy objects, frequent constipation, and genetic pelvic floor weakness.
Mild and moderate cases can often be treated with non-surgical interventions. However, severe cases of bladder prolapse may require surgery to keep vital pelvic organs in their correct positions.
Symptoms
There are several common symptoms that are present in most cases of bladder prolapse. These symptoms include:
- A feeling of pressure or fullness in the pelvis and vagina
- A bulge of tissue in the vagina that is visible
- Increase in pelvic pressure when coughing, straining, or lifting
- Difficulty urinating or starting a stream of urine
These symptoms tend to be most prevalent after standing up for extended periods of time. Signs of bladder prolapse may fade away when patients lie down.
Diagnosis
There are several ways to diagnose a bladder prolapse cystocele. These include:
Pelvic Exam
The most effective way of diagnosing a prolapse is through a pelvic exam. You may be examined while standing or while lying down. During the examination, your physician will look for a visible tissue bulge in your vagina. A bulge is a strong indicator of bladder prolapse.
Your doctor will likely ask you to exert yourself as if you are having a bowel movement. This allows them to determine how much that action impacts the degree of your prolapse. They will also ask you to contract your pelvic muscles so that they can check for normal strength.
Questionnaire
Your physician may provide you with a questionnaire so that they can assess how much the prolapse is affecting your overall quality of life. This will guide their treatment.
Urine and Bladder Tests
Patients with a significant prolapse may not be able to adequately empty their bladders. If your physician is concerned that your bladder prolapse is severe, then they may run tests on your urine to check for bladder infections.
Treatment
The right treatment for you will depend on the severity of your bladder prolapse cystocele symptoms. Patients that are experiencing severe discomfort and urinary incontinence will likely require surgical intervention. Milder cases can be treated with non-invasive options.
The three primary treatment options include:
Home Exercises
Pelvic floor muscles exercises are a great way of providing added support to your pelvic organs. These exercises are successful at relieving many milder symptoms of bladder prolapse cystocele when performed correctly. Your doctor or a licensed physical therapist can provide you with detailed instructions on how to perform these exercises.
Pessary
A pessary is a supportive device that is inserted into your vagina. It is a rubber or plastic ring that offers added support to relieve prolapse symptoms. Your doctor will show you how to clean the device and reinsert it without assistance. These devices can buy time and allow you to delay surgery.
Surgery
Surgical treatment for bladder prolapse cystocele is performed vaginally. During the procedure, the physician will hold the bladder into place with stitches. They will also remove excess vaginal tissue, if necessary.
In some cases, a hysterectomy is performed at the same time. This is done to alleviate other issues, such as cancer or excessive bleeding.