Bladder prolapse, or cystocele, is caused by stress on the pelvic muscles from heavy lifting, obesity, chronic coughing, menopause, pelvic surgery or multiple pregnancies, according to the American Urological Association. When the muscles and tissues holding the bladder in position stretch and weaken, the bladder droops into the vagina, causing frequent urination, pain, urinary tract infections and painful intercourse. If left untreated, the prolapse worsens and the bladder may protrude through the vaginal opening. In severe cases, the patient may be unable to urinate, eventually causing kidney damage. Treatment depends on the severity of the condition.
Kegel Exercises
No treatment is required if the condition doesn't bother the patient. For mild symptoms, self-care measures such as pelvic exercises may be sufficient, according to the Mayo Clinic. Kegel exercises can help strengthen the pelvic floor muscles and reduce urinary incontinence. Patients are taught to pull in the pelvic floor muscles, hold for three seconds and relax for three seconds, working up to 10 to 15 repetitions, three times a day.
Vaginal Support Device
Patients with mild symptoms and urinary incontinence may find relief by using a pessary or vaginal support device, the American Urogynecologic Society reports. The plastic ring works by lifting the bladder or compressing the urethra to reduce leakage during exercise. Estrogen in tablet or vaginal cream form is often prescribed in addition to the pessary to strengthen vaginal tissues. Pessaries can be used long term if needed, or as a temporary measure to reduce symptoms before surgery, the Mayo Clinic reports. Women who plan to have more children may prefer to delay surgery and use a pessary in the meantime.
Surgical Intervention
Pelvic reconstruction surgery may be necessary to restore the patient’s normal pelvic anatomy and improve her quality of life, according to the American Urogynecologic Society. Repairing a bladder prolapse or cystocele involves elevating the vaginal wall and supporting the bladder using either a vaginal or abdominal approach. Mesh grafts are sometimes used to reinforce the ligaments, but more research is needed to determine if the technology improves long-term results. Even after surgical repair, the cystocele may recur and a second procedure may be needed, the Mayo Clinic reports. Women who become pregnant after pelvic reconstruction surgery may require a cesarean delivery.
