A prolapsed bladder, or cystocele, occurs when the pelvic floor muscles and ligaments become weakened or stretched, causing the bladder to sag against or into the vagina. According to the American Urological Association Foundation, stress on the area during childbirth is a significant factor in the later development of a prolapsed bladder. Symptoms of the condition range from mild to severe, depending on the extent of the prolapse.
A prolapsed bladder can be a painful condition, particularly if part of the bladder begins to droop into the vagina. When this happens, you may feel as if a small ball is in your vagina when you are standing. Sitting or lying down usually relieves the sensation. In addition to discomfort, you may experience a feeling of pressure in your vagina. Because bladder tissue is encroaching on the vagina, sexual intercourse can be uncomfortable, as your partner's penis may press against the bladder causing pain or even the release of urine.
You may also experience pain in your abdomen, groin, lower back or pelvis due to the effects of the prolapse on your entire pelvis. In some cases, bladder prolapse occurs in conjunction with prolapse of other organs. If you experience pain in the abdomen, groin, pelvis or back, your doctor may want to determine if other pelvic organs, such as the uterus, vagina, bowel or rectum, are also prolapsed.
Because your bladder is not being properly supported, you may notice a range of urinary symptoms. It may feel as though your bladder isn't completely empty when you urinate or you may feel a continual need to urinate. A prolapsed bladder may lead to frequent bladder infections. Your bladder may not be able to handle the stress when you laugh, sneeze or cough and you may experience leakage of urine. In some cases, urinating can be painful.
Women who have had multiple pregnancies or have had vaginal deliveries have a higher chance of developing a prolapsed bladder. Straining during bowel movements, constipation, chronic coughing, heavy lifting and obesity can increase the risk of developing the condition. Pelvic floor weakness can occur in women who have had their uteri removed or in women who have had other types of pelvic surgery. Nerve and muscle function decreases with age, putting you at higher risk of developing bladder prolapse as you age. The body requires oestrogen to keep pelvic muscles strong, and as a woman's oestrogen level decreases after menopause, she may develop the symptoms of a prolapsed bladder.
Kegel exercises, special exercises that strengthen the pelvic floor muscles, may help control urine leakage. Oestrogen replacement therapy can also help improve muscle strength. In some cases, a pessary may be needed to support the bladder. A pessary is a plastic device that is inserted into your vagina, much like a diaphragm, and forms a barrier to the prolapse. In severe cases of prolapsed bladder, surgery may be needed to move the muscles and ligaments back into their normal positions.