What are the causes of a prolapsed bladder? What are the symptoms of a prolapsed bladder? When should you seek medical care for a prolapsed bladder? What exams and tests are used to diagnose a prolapsed bladder? What are the treatment options for a prolapsed bladder?

Understanding Pelvic Organ Prolapse

Pelvic organ prolapse is a condition in which one or more of the pelvic organs, such as the vagina, uterus, bladder, urethra, or rectum, drop from their normal position. This is caused by injury to the muscles or tissues that support these organs. The main cause of pelvic organ prolapse is pregnancy and childbirth, especially vaginal delivery. Other factors that can contribute to prolapse include aging, obesity, and genetic predisposition.

Types of Pelvic Organ Prolapse

There are several different types of pelvic organ prolapse that can occur:

• Uterine Prolapse: The uterus drops down into the vagina, and in severe cases, may protrude outside the vagina.
• Anterior Vaginal Wall Prolapse (Cystocele): The bladder drops down and creates a bulge in the front wall of the vagina.
• Posterior Vaginal Wall Prolapse (Rectocele): The rectum drops down and creates a bulge in the back wall of the vagina.
• Uterovaginal Prolapse: A combination of organs, such as the bladder, uterus, and rectum, shift downward.

Prolapse After Hysterectomy

Pelvic organ prolapse can also occur after a hysterectomy (removal of the uterus). The following types of prolapse can happen in this situation:

• Anterior Vaginal Wall Prolapse (After Hysterectomy): Bladder prolapse can occur without a uterus.
• Vaginal Vault Prolapse (After Hysterectomy): The top of the vagina drops down, creating a bulge.
• Posterior Vaginal Wall Prolapse (After Hysterectomy): The rectum can drop downward, creating a bulge in the back wall of the vagina.

Causes of a Prolapsed Bladder

The primary cause of a prolapsed bladder, also known as a cystocele, is weakening of the pelvic floor muscles and tissues that support the bladder. This can happen due to:

• Pregnancy and childbirth, especially vaginal delivery
• Chronic straining, such as from constipation or heavy lifting
• Obesity
• Loss of estrogen after menopause
• Genetic factors that predispose someone to pelvic floor weakness

Symptoms of a Prolapsed Bladder

The most common symptoms of a prolapsed bladder include:

• A feeling of pressure, fullness, or bulge in the vagina
• Difficulty urinating or having a bowel movement
• Incontinence or leakage of urine
• Recurrent urinary tract infections
• Painful intercourse

Diagnosing a Prolapsed Bladder

To diagnose a prolapsed bladder, your healthcare provider will perform a physical exam and may order additional tests, such as:

• Pelvic exam to visually inspect the vagina and assess the degree of prolapse
• Urodynamic testing to evaluate bladder function
• Imaging tests like ultrasound or MRI to get a better view of the pelvic organs

Treating a Prolapsed Bladder

Treatment for a prolapsed bladder depends on the severity of the condition and your individual needs. Options may include:

• Nonsurgical treatments: Pelvic floor exercises, vaginal pessaries, or other supportive devices
• Surgical treatments: Procedures to lift and support the prolapsed bladder, such as sacrocolpopexy or vaginal wall repair

Your healthcare provider will work with you to determine the best course of treatment based on your specific situation.

Preventing a Prolapsed Bladder

To help prevent a prolapsed bladder, you can:

• Maintain a healthy weight and avoid obesity
• Practice pelvic floor exercises, such as Kegels, to strengthen the pelvic muscles
• Avoid straining with bowel movements or heavy lifting
• Consider estrogen therapy after menopause to help maintain pelvic floor health

With proper treatment and lifestyle management, many people with a prolapsed bladder can manage their symptoms and maintain a good quality of life.