Bladder collapse, also called bladder prolapse or cystocele, affects women when the tissue between the bladder and the vagina weakens. Cystocele most commonly occurs in women after pregnancy and vaginal delivery. Age, obesity, menopause and a history of heavy lifting increase the risk of developing cystocele. Cystocele is graded as grade 1, 2 or 3, depending on how far the bladder falls into the vagina. In grade 3, the bladder bulges out of the vagina. Symptoms that affect quality of life may require surgery. Around 18,500 cystocele repairs were done in 2002, the Encyclopedia of Surgery reports.
Urinary Symptoms
The most common effect of cystocele is urinary incontinence, or voluntary loss of urine. Stress incontinence occurs when a woman cough, sneezes or laughs, or during other physical activity. Urinary frequency, urgency, trouble urinating or an inability to fully empty the bladder may occur. Incomplete emptying can lead to frequent urinary tract infections. Leakage during sex may also occur.
Vaginal Symptoms
Cystocele can cause the bladder to bulge out of the vagina, causing discomfort when sitting. Standing can cause an uncomfortable feeling of pelvic or vaginal pressure or fullness. Straining or bearing down can cause increased pressure and discomfort. In mild cases of cystocele, doing Kegel exercises tightens and strengthens the pubococcygeus muscle, which helps support the pelvic floor, the Merck Manual reports. Moderate cases are helped by use of a pessary, a device inserted into the vagina to hold the bladder in place.
Pain
Pain in the vagina or lower back, or pain during sex can occur from severe prolapse. Vaginal pressure can also become painful. Pain or severe urinary symptoms, usually caused by grade 3 or grade 4 prolapse, may require surgical repair. Surgery tightens the muscles of the pelvic floor; however, the condition can recur over time, and surgery may need to be repeated. If necessary, surgery should be postponed until after childbearing is completed, MayoClinic.com suggests.
