The walls of a woman's vagina help support and maintain the bladder in its correct anatomical position. During childbirth, the muscles of the vagina are put under intense pressure. The walls stretch and even tear. The vagina heals after childbirth, but may never quite regain its original strength. Occasionally the walls of the vagina weaken to the point where the bladder slips out of its correct position. The dropped bladder, referred to as a prolapsed bladder, may become partially positioned outside of the abdomen.

Childbirth and menopause are the main risk factors for bladder prolapse. Estrogen levels, which help keep the vaginal walls toned, fall sharply after menopause. This sudden change in hormone levels can lead to a dropped bladder. Menopausal women who have had children (with or without a bladder prolapse after birth) comprise a high-risk group for prolapsed bladder.

Women suffering from a dropped bladder often experience urine leakage. Stress incontinence is also common: laughing, coughing and other activities that push the abdominal muscles down on the dropped bladder squeeze urine out of the bladder opening.

 

A prolapsed bladder is uncomfortable; women feel a pressure in the vagina that feels almost as if a small ball were lodged inside. Bladder tissue exposed through the opening of the vagina becomes raw and painful. Sexual function also suffers.

You may hear doctors refer to a prolapsed bladder as a cystocele. This is simply the medical term for bladder prolapse, and means essentially the same thing.

A vaginal examination is required to diagnose a prolapsed bladder. The patient is sometimes asked to cough or push so that the position of the bladder can be evaluated carefully.

Treatment depends on the severity of the prolapse. For mild cases, all that may be required is muscle tightening with Kegel exercises. These exercises strengthen the vaginal walls so the vagina can hold the bladder in its correct position. Post-menopausal women may benefit from estrogen therapy to strengthen muscle tone. Vaginal lubricants can also help to limit irritation of the vagina.

 

Pessaries are devices that a doctor can insert into the vagina to hold the bladder in its correct position. While pessaries can irritate the bladder and urethra, if the patient doesn't experience any irritation, they work well in treating dropped bladders.

 

Serious cases of bladder prolapse require surgery to reposition
the bladder and restore support of the bladder by the insertion of stitches in the front and back walls of the vagina.

 

Resources

University of Iowa Health Care. (updated 2001).
Prolapsed bladder or rectum. Retrieved March 7, 2002, from www.uihealthcare.com/topics/womenshealth/wome3275.html.

McLaughlin, Eileen, RN, BSN. (updated 2001). Cystocele.
Retrieved March 7, 2002, from health.discovery.com/diseasesandcond/encyclopedia/2163.html.

University of Maryland Medicine. (nd). Cystocele (fallen bladder). Retrieved March 7, 2002, from www.umm.edu/urology-info/cystocel.htm.