Under normal conditions, a woman’s bladder is held in place by a net of pelvic floor muscles and connective tissues. When these muscles and tissues stretch and weaken, it allows the bladder to “drop” or prolapse through this net or wall. A prolapsed bladder is one in which the bladder decends into the vagina following the deterioration of the vaginal wall. A proposed bladder is also known an as a cystocele or a fallen bladder.
The bladder itself is the hollow organ in the pelvis that serves as a storage unit for our urine. This urine is filtered from the body through the kidneys and makes its way down to the bladder. Once the bladder is full, pressure from the urine creates the urgency to urinate. It is during urination that the bladder is emptied, as urine travels out of the bladder (and body) through the urethra.
So how or why do women experience bladder prolapse? Typically the front wall of the vagina, the one that acts as a mesh to support the bladder can weaken and loosen as women age. This is especially significant with the onset of menopause, when a woman’s body stops producing estrogen. Before menopause, estrogen is one of the factors that aids in keeping the pelvic muscles tight and strong. Once this hormone is no longer being produced, pelvic muscles weaken as a result, leading to increased incidence of bladder prolapse. Intense pelvic stress, such as that experienced during childbirth can cause damage to the anterior vaginal wall and lead to bladder prolapse.
What causes a prolapsed bladder?
Here are several factors that are commonly associated and can cause a prolapsed bladder:
- Childbirth: This is said to be the most common cause of bladder prolapse
- Menopause: as mentioned, the estrogen hormone which helps to maintain strength of pelvic and vaginal muscles, stops being produced after menopause
- Intense straining: Heavy lifting, intense straining during bowel movements, or long-term constipation can damage and deteriorate the pelvic floor muscles
Prolapsed bladders are categorized into 4 grades, mild, moderate, severe, and complete prolapse. These stages are based on how far into the vagina the bladder drops.
Grade 1 (mild): Small portion of the bladder drops into the vagina
Grade 2 (moderate): The bladder drops enough to reach the vaginal opening
Grade 3 (severe): The bladder bulges out from the body through the opening of the vagina
Grade 4 (complete): The entire bladder protrudes completely outside the vagina
What are the symptoms of a prolapsed bladder?
Bladder prolapse can initiate issues like trouble urinating, incontinence, leakage (especially during sneezing, coughing, or lifting), and discomfort. A lot of women with mild bladder prolapse, or grade 1, don’t notice any symptoms. It is not until the condition worsens that they notice something abnormal. Many women first notice the issue when they feel a ball like tissue present in the vagina, something that was not there before. Other symptoms of a prolapsed bladder include the following:
· Discomfort and pain in the pelvis
· Ball-like tissue protruding from the vagina
· Difficulty urinating
· Incomplete voiding, or emptying of the bladder
· Stress incontinence (leaking while sneezing, coughing, lifting or getting up)
· Increased frequency of bladder infections
· Painful intercourse
· Lower back pain