HysterSisters Articles for Hysterectomy
SHARING IS CARING
Prolapse | Bladder (Cystocele)
From the Pelvic Floor Articles List
I think my bladder is prolapsing. What testing do I need and what are my treatment options?
When the muscles and tissues supporting the bladder weaken or stretch, the bladder may fall from its normal position. This can cause it to press against the vaginal wall and even protrude into the vagina. A prolapsed bladder is known as a cystocele. There are several risks factors for a prolapsed bladder along with a variety of treatment options.
The supporting structures for the bladder can be compromised in many ways. These can include being pregnant and/or giving birth, being overweight, lifting heavy objects, straining, having a chronic cough, having inadequate estrogen, and/or having a genetic history of prolapse. If there is an underlying reason for your prolapsed bladder (such as low estrogen or constipation), it needs to be addressed along with the prolapse.
There are four grades of bladder prolapse:
- Grade 1/Mild: The bladder only falls slightly, so there may be no symptoms.
- Grade 2/Moderate: The bladder falls into the opening of the vagina, so symptoms are likely.
- Grade 3/Severe: The bladder protrudes through the vagina causing symptoms to increase. Women tend to experience pain and discomfort.
- Grade 4/Complete: The bladder falls outside the vagina worsening symptoms. At this stage women often experience other pelvic organ prolapses as well.
Women with bladder prolapse may experience pelvic pain or discomfort, lower back pain, and pain with intercourse. Urination issues can include incomplete voiding, difficulty urinating, and multiple bladder infections. Additionally, women with a cystocele may endure some embarrassing symptoms such as leaking urine when sneezing, coughing, or laughing. Finally, women may find they have a bulge in the vagina. Those with a mild cystocele may not have any noticeable symptoms, while those with a complete prolapse may experience multiple symptoms.
Your doctor may perform a variety of tests to help determine if you have a cystocele. For a moderate or complete prolapse, a pelvic exam conducted both lying down and standing may be enough for diagnosis. For less severe cases, other testing may be needed:
- Voiding Cystourethrogram: A series of X-rays taken during voiding.
- Urodynamics: This test measures the volume and pressure relationships in the bladder. This test is sometimes referred to as an EKG of the bladder.
- Cystoscopy: A scope is used to look inside the bladder.
Cystocele treatment options can depend on the grade of prolapse and symptoms. There are both surgical and non-surgical choices, but either way, you should avoid heavy lifting and straining to promote a successful treatment outcome.
- For early prolapse, a pessary may be effective. It is placed inside the vagina to hold the bladder in place.
- Vaginal estrogen may also be prescribed with a pessary, or another form of estrogen may be prescribed separately.
- Exercises and physical therapy may be helpful to strengthen the pelvic floor. Your doctor may suggest Kegel exercises and may recommend using biofeedback to determine if other exercises would be beneficial.
- Electrical stimulation may strengthen and activate the pelvic floor muscles.
- Mesh or tissue grafting may be used to strengthen the vaginal wall.
- Stitches may be placed to re-anchor the bladder.
- A bladder sling could be used to pull the bladder back into place.
- If the uterus has also prolapsed, a hysterectomy along with repairs to the pelvic floor may be necessary.
While a gynecologist or urologist may be able to help, the HysterSisters recommend finding a knowledgeable urogynecologist. These types of physicians specialize in both the gynecological and urological systems and thus may be able to offer the most appropriate treatment. As always, not all options are right for each woman, so weigh your own pros and cons carefully. Additionally, the HysterSisters advocate a second opinion before making any major decisions or scheduling a surgery.
This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.
06-10-2013 - 11:52 AM
SHARING IS CARING
Do you have a question?
If you have a medical support question related to this article, come JOIN US in our HysterSisters Community Forums. You will receive helpful replies to your questions from our members. See you there!
Recommended for Hysterectomy Recovery
Mesh panties are stretchy and light - perfect for holding peri pads securely during hysterectomy recovery. [...More]
Post-operative compression panty with medical grade silicone to speed hysterectomy recovery + reduce scarring. [...More]
Softest Bra Ever
When you want to wear something, but feel nothing. Two in a value pack for your hysterectomy recovery. [...More]
Options to Hysterectomy
Hormone and Menopause
Intimacy after Hysterectomy
Fitness after Hysterectomy
Grief and Loss
Ask A Doctor
Find a Surgeon
|Shaghayegh DeNoble, M.D.
20 Wilsey Square
Ridgewood NJ 07450
|Lori Warren, M.D.
3900 Kresge Way
Louisville KY 40207
|Kirsten Sasaki, M.D.
120 Osler Drive, Suite 100
The Advanced Gynecologic Surgery Institute
Naperville IL 60540
|Tamer Seckin, M.D.
872 FIFTH AVE
NEW YORK NY 10065
|Ted Lee, M.D.
Magee Womens Hospital
300 Halket Street
Pittsburgh PA 15213
412 641 6412
|Arnold Advincula, M.D.
Columbia Ob/Gyn Midtown
51 West 51st St, 3rd FL
New York NY 10019
|Mayra J. Thompson, M.D.
5323 Harry Hines Blvd Dept OBGYN
Dallas TX 75290
|Lillian Schapiro, M.D.
3200 Downwood Circle, Suite 220
Atlanta GA 30327
|Tiffany Jackson, M.D.
601 Clara Barton, Suite 160
Garland TX 75042