Bladder prolapse is a common condition. Used to store urine, the bladder is a hollow organ in the pelvis. Pressure created when the bladder fills with urine is what causes the urge to urinate when urine travels from the bladder and out the body through the ureter. In women, the uterus, or womb is held in place by the muscles, tissues and ligaments in the pelvis. Prolapse occurs when these supporting muscles, tissues and ligaments become weaker and are unable to hold the uterus in place.
There are varying degrees of prolapse:
- First degree prolapse – when the uterus slips down into the vagina
- Second degree prolapse – when part of the uterus sticks out of the opening of the vagina
- Third degree prolapse – also called procidentia – when the entire uterus slips outside the vagina
Some women experience no symptoms and the condition is only discovered when they are examined internally for other reasons. However, most women will experience symptoms, including:
- The feeling that something has dropped down below
- Difficulty with sexual intercourse
- Difficulty opening bowels
- A feeling that the bladder is not empty after urinating
Causes of prolapse
The main factors commonly associated with causing a prolapsed bladder are:
- Straining: Anything from lifting heavy products, straining during bowel movement, long-term constipation which causes damage to the muscles of the pelvis floor.
- Childbirth: The most common cause, the childbirth delivery process is stressful on the vaginal tissues and muscles which support the bladder.
- Menopause: Oestrogen, the hormone which maintains the strength of the vaginal muscles, is no longer produced after menopause, causing the muscles to weaken.
Your consultant will examine the pelvis and a bladder that has entered the vagina will confirm the diagnosis. In less obvious cases, the consultant may use a series of X-Rays taken during urination to help determine the shape of the bladder and the cause of urinary difficulty.
Following diagnosis, your consultant may test the nerves, muscles and the intensity of the urine stream to determine what type of treatment is most appropriate.
Cytoscopy may also be used to determine the best form of treatment; this procedure involves looking into the bladder with a scope.
Grade 1 prolapse that produces no pain or discomfort usually requires no medical or surgical treatment. However, your consultant may recommend you avoid lifting or straining.
For more serious cases, your consultant will assess the woman’s age, health, treatment of preference and the severity of the prolapse in order to determine which treatment is appropriate.
Non-surgical treatments include:
- Pessary: A pessary is placed into the vagina to hold the bladder in place; pessaries should be removed and cleaned at regular intervals to prevent infection. Oestrogen cream is also used to help prevent infection.
- Oestrogen replacement therapy: Oestrogen helps strengthen and maintain the muscles in the vagina.
London Urology is an expert clinic comprising of world-class Consultants able to treat a variety of conditions. Prolapse is a common condition treated by the clinic and we encourage you to contact us with any questions you may have regarding Prolapse treatment or to book an appointment. You can call us on 020 7432 8297 or email us at [email protected].