Urinary bladder is a muscular sac which stores urine. It is a part of the urinary system. When the person gets an urge to urinate, the bladder contracts and facilitates stored urine to pass out through the urethra. You often come across elderly women with a peculiar complain, a feeling of ball in their vagina, or something protruding in the vagina.
Prolapsed bladder is a women’s disorder. Medically termed as cystocele, prolapsed bladder occurs as a result of weak vaginal wall. In women the front portion of vaginal wall supports the bladder. When this wall becomes weak as a result of multiple pregnancies or due to aging, it is unable to support the bladder to stay in its place giving rise to a condition called prolapsed bladder or cystocele.
Urinary difficulties such as leakage of urine while sneezing, coughing or repeated bladder infection come along with prolapsed bladder. For a mild to moderate prolapse, conservative treatment is often effective. But when the bladder protrudes out of the vagina it requires nothing less than surgical repair.
Causes And Risk Factors For Prolapsed Bladder
One thing from above discussion is clear and that is prolapsed bladder is a result of weak muscles and ligaments of pelvic floor and vaginal wall.
- Multiple pregnancies and deliveries is one of the most common risk factor that may cause bladder prolapse. During childbirth there is extreme stress on the muscles and ligaments of vaginal wall. Repeated pregnancies can make the vaginal muscles weak. However, it does not mean that every woman who had multiple deliveries suffer from cystocele, ultimately it all depends on the strength of vaginal muscles of an individual woman.
- Old age: menopause is a natural event of old age in women. It is complete cessation of menses. Estrogen is a hormone which keeps the muscles of vagina strong. But after menopause, usually after 50 years, estrogen production is decreased and thus the muscles of vagina start becoming weak.
- Straining: Obesity in women, women lifting heavy objects repeatedly, straining due to constipation or pressure on the pelvic floor muscles due to chronic cough are few other contributory factors for developing prolapsed bladder.
Symptoms Of Cystocele
Mild stage of prolapsed bladder may not be noticed by a woman. But when the bladder protrudes down in the vagina in severe stage, the first feeling she may experience is that of something like ball in vagina. This may give a feeling of fullness in the vagina especially when she is standing.
There may be mild pain and discomfort. She may have feeling that the bladder is not completely emptied and thus she visits the bathroom frequently. There is leakage of urine when she coughs and sneezes or even when she lifts a heavy object. She complains of frequent bladder infection.
How To Treat A Prolapsed Bladder?
If a woman notices symptoms of prolapsed bladder, she should immediately contact her doctor. The doctor can diagnose it after doing pelvic examination. After evaluating the stage, whether it is mild, moderate or severe, the age of patient her general health the doctor plans out treatment.
- In mild to moderate cases where cystocele is not too large and protruding completely out of the vagina, conservative treatment is generally preferred. It includes placing a pessary inside the vagina which supports the vaginal wall and hold the bladder in its place.
- Estrogen replacement therapy is useful in many menopausal women who have prolapsed bladder. Estrogen strengthens the vaginal muscles and ligaments. It can be taken in the form of pills or estrogen vaginal cream can be applied locally in the vaginal area.
- Patients are also advised to do Kegel’s exercise. It is an exercise which strengthens the pelvic muscles.
- Patient may be advised to modify her lifestyle, avoid lifting heavy objects, and avoid constipation by eating more fiber containing food.
- Lastly if the prolapsed bladder is in severe stage which compromises the daily activity of the patient and becomes very discomforting, surgical repair is to be thought of.