What is Bladder Prolapse?
I have a feeling that most school vocabulary tests didn’t include the word “prolapse,” but not to worry, because we’ve got you covered. The word prolapse literally means ‘falling out of place.’ And if you toss the word bladder in front of that, then you’ve got a bladder falling out of place. The medical world refers to this condition as cystocele, but I’m sure we can all agree that bladder prolapse is a lot easier to remember.
But Wait, Where Does The Bladder Fall?
Now you’re probably wondering, if the bladder falls out of place, where does it go? Well, my friends, it bulges or drops into the front wall of the vagina and here’s why. Think of your pelvic floor as a support system. It’s tasked with the job of providing support to the organs that lie on it, but sometimes it gets weakened or stretched. Over time, these changes can lead to a drooping bladder and spontaneous drips (aka incontinence).
How Does That Happen: Risk Factors
In short, anything that puts pressure on the pelvic floor can cause bladder prolapse. That means events like pregnancy, childbirth, and even repeatedly lifting a child puts you at risk. Aren’t we lucky? Other risk factors include:
- Carrying a little extra weight
- Certain exercises
- Constipation or straining on the toilet to empty the bowel or bladder
- Family history
- Having another type of pelvic prolapse
Menopause is a Risk Factor Too
Menopause brings about a lot of change and some of those changes impact your pelvic floor. Hormones like estrogen keep the vaginal muscles strong and flexible but those levels drop during and after menopause. As a result, the support system that we call the pelvic floor lets the bladder ease on into the vagina like an uninvited guest.
How Would I Know If Bladder Prolapse Is Affecting Me?
Bladder prolapse comes with some symptoms that are pretty hard to ignore, so you may not know that you have it, but you’ll at least know that something is not right. Stress incontinence is one symptom that a lot of women with bladder prolapse experience. That’s when you laugh, cough, or do another activity that puts pressure on the bladder and it causes bladder leaks. Another symptom is feeling like you still need to pee even though you’ve just gone. The most common symptom with bladder prolapse, though, is feeling like there’s a ball in your vagina. Other symptoms to look for include:
- Pelvic heaviness/fullness
- Frequent or urgent urination
- Feeling like something is falling out of your vagina
- Having a hard time starting a urine stream
- Pelvic and/or lower back discomfort
- Painful sex
- Inability to completely empty the bladder in more severe cases (e.g. urinary retention)
Diagnosis of Bladder Prolapse
If you think you’re dealing with a prolapsed bladder, then the best thing to do is to see your primary care physician. They’ll go through the process of asking about your symptoms, medical history, and performing various tests to rule out other conditions. The most common tests are:
- Bladder scan: They’ll likely have you pee and then measure how much urine is left in the bladder afterward (e.g. post-void residual).
- Pelvic ultrasound: They’ll check the area for any masses or cysts.
- Mid-stream urine test: To rule out any possible infections.
- Voiding cystourethrogram: This x-ray exam allows your healthcare provider to see your bladder while peeing.
And You’ll Also Get a Grade
Once tests are out of the way and bladder prolapse is confirmed, then a grade will be assigned. The grade is based on how far the bladder has dropped into the vagina, which also determines its severity. The good news is, although bladder prolapse is a pain in the vagina, it’s not considered life-threatening. The grading system looks something like this:
- Grade 1: Mild. The bladder droops a little bit into the vagina.
- Grade 2: Moderate. The bladder drops down low and is close to the vaginal opening.
- Grade 3: Severe. The bladder bulges out through the opening of the vagina.
Is Bladder Prolapse Treatable?
The treatment given for bladder prolapse is largely dependent upon how severe your case is. For instance, someone with Grade 1 may have little to no symptoms. In this case pelvic floor exercises, weight loss, addressing constipation, and using a bladder leak product to catch drips might do the trick (psst…Lily Bird can help with that).
Moderate cases of bladder prolapse may require a little more than self-help. Your doctor might refer you to a physiotherapist who will review how your pelvic floor currently functions and give you tips on doing exercises to strengthen those muscles. In some cases, a pessary ring is needed to support the bladder. Surgery is a last resort and is usually recommended for those with a more severe prolapsed bladder. The type of technique that’s used in surgery is based on the combination of prolapse and urinary symptoms. The most common techniques include either tape, tissue graft, or supportive mesh to hold the bladder in place.
And That’s All On Bladder Prolapse
If it feels like something is falling into your lovely lady parts, then bladder prolapse just might be the culprit. Most ladies, especially those over 50, will experience some type of pelvic prolapse. So if you thought it was just you, trust us, you’re not alone! And fortunately for us all, there are solutions.
Is an unruly bladder one of the things that’s stopping you from living your best life? Lily Bird can help. Lily Bird has you covered with pads and underwear delivered right to your door. Start your trial today.
By Jessica Thomas, MPH