October 29th, 2015
The bladder is a hollow muscular organ that is held in place by the muscles of the pelvic floor, which form a sling or hammock. With age and childbirth, the muscles of the pelvic floor can stretch or become weak, which allows the bladder to drop. The bladder then bulges out into the vagina and may even appear or protrude through the opening of the vagina, in severe cases. This is known as a cystocele.
The primary cause of bladder prolapse is stress on the muscles of the pelvic floor during childbirth and pregnancy. Women with multiple pregnancies are at greater risk of bladder prolapse. Vaginal deliveries and difficult or long deliveries are both associated independently with bladder prolapse. Some other causes include constipation and straining with bowel movements; obesity; the decline in estrogen levels after menopause; prior pelvic surgery; heavy lifting; and chronic coughing.
Most people notice a vaginal bulge initially. There may be tissues protruding from the vagina that is bleeding or tender. Other symptoms and signs of a prolapse of the bladder include urinary incontinence, frequent urinary tract infections, frequent urges to urinate, and heaviness, pressure, or pain in the vagina, pelvis, groin, abdomen, or in the low back. Sexual intercourse may be painful.
Doctors diagnose bladder prolapse after taking a detailed history of your symptoms and performing a pelvic examination. This will allow your physician to determine how severe your prolapse is. You may be asked to strain, push, or stand during the exam. There are also some imaging studies that are useful to examine the pelvic floor and the bladder. Cystoscopy, urodynamic studies, x-rays, ultrasound, and MRI are all used at times to provide an accurate evaluation.
If you have bladder prolapse, your doctor may recommend a trial of conservative treatment. This can include kegel exercises to strengthen the muscles of the pelvic floor; physical therapy; use of a pessary, which is a vaginal support device; and replacement of estrogen. If your bladder prolapse is not causing problems and not blocking the flow of urine, your doctor may recommend no treatment at the present time. Surgeries to add support to the bladder can be performed through the abdomen or the vagina. These techniques include open surgery, minimally invasive surgery, laparoscopic surgery, and robotic laparoscopic surgery. Your surgeon may recommend repair of your own pelvic floor tissues or placement of a graft or mesh to support the bladder.
If you are concerned that you have bladder prolapse, call your physician or urologist for a consultation to discuss your treatment options. In some cases, severe prolapse can obstruct the kidneys or prevent urination in kidney damage. Call today for an appointment with xxxx, a leading xxxx urologist.
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