The bladder stores the urine in the body prior to urination. In women, it’s supported, or held in place, by the front wall of the vagina and the pelvic floor muscles. When those muscles become too weak, the bladder can dropout through the vagina. The condition is known as bladder prolapse.
There are many factors which can contribute to weakened vaginal and pelvic floor muscles. For instance, pregnancy and childbirth often weaken the muscles and women who have had several children are particularly at risk. Being overweight also strains the muscles and may weaken them. As women age, estrogen levels usually drop and this may also lead to a decrease in muscle tone.
Symptoms of bladder prolapse include incontinence, which means urine leaks out. This often occurs during coughing or sneezing. Other symptoms may include pain in the low back, pelvic area and painful sexual intercourse. A diagnosis is usually made through a physical exam and a cystoscopy, which allows a doctor to view the bladder through a scope.
Treatment will usually depend on the degree of prolapse. For example, if only a small portion of the bladder has dropped into the vagina, the prolapse is considered mild. Treatment may include strengthening exercises such as Kegel exercises. Kegels are performed by contracting and relaxing the muscles which control the flow of urine from the body.
In more severe cases of a bladder prolapse, such as when the a larger part of the bladder had dropped into the vagina, more intense treatment may be needed. One type of treatment is called a pessary. This is a non-surgical treatment performed to hold the bladder in place. A small, removable device is inserted into the vagina, which keeps the bladder from dropping.
Other non-surgical treatments include, electrical stimulation. Small electrical currents are administered to the muscles of the pelvic floor. This helps strengthen the muscles, and keep the bladder in place. Since a lack of estrogen may weaken the muscles, estrogen replacement hormones may be given.
Biofeedback may also be used to treat bladder prolapse. A sensor is placed inside the vagina, which can monitor the function of the muscles. Exercises are prescribed and the sensor can help doctors determine if the exercises are targeting the correct muscles. If they are not, different exercises to strengthen the muscles may be suggested.
When non-surgical treatments for bladder prolapse have not corrected the situation, surgery may be required. Most surgery is performed through the vagina and is done on an outpatient basis. During the procedure, the bladder is returned to its correct location and secured in place.
Many times, bladder prolapse can be prevented. Avoid staining during bowel movements, which can weaken muscles. Eating a diet high in fiber and drinking plenty of water may help reduce straining. Stay at a healthy weight, and do Kegel exercises, which help strengthen the muscles.