A prolapsed bladder, rectum, or vagina is characterized by the stretching or weakening of the pelvic floor muscles that hold up the pelvic structures.
Symptoms of Prolapse
The first symptom that women with a prolapse usually notice is the presence of tissue in the vagina that may feel like a ball.
Other symptoms of prolapse include the following:
- Pelvic or vaginal pressure
- Tissue protruding from the vagina (In severe cases, the tissue may be tender and may bleed)
- Difficulty urinating
- A feeling that the bladder is not empty immediately after urinating (incomplete voiding)
- Stress incontinence (urine leakage during sneezing, coughing or exertion)
- Increased urinary frequency and urgency
- Frequent bladder infections
- Difficulties evacuating stool from the rectum
- Painful intercourse (dyspareunia)
- Low back pain
Leading Causes of Prolapsed Bladder
- Childbirth: This is the most common cause of prolapse. The delivery process is stressful on the vaginal tissues and muscles that support a woman’s pelvic structures.
- Menopause: Estrogen, a hormone that helps maintain the strength and health of muscles in the vagina, is not produced after menopause. Prior to menopause, women’s bodies create estrogen, which helps keep the muscles in and around the vagina strong. However, after our bodies stop creating as much estrogen, those muscles tend to weaken and lead to prolapse.
- Hysterectomy: A hysterectomy with removal of the ovaries leads to surgical menopause. This creates loss of estrogen leading to weakness of the pelvic floor and vaginal muscles. A hysterectomy alone can alter the integrity and support of the vagina, leading to prolapse.
- Straining: Lifting heavy objects, straining during bowel movements, having a long-term condition that involves coughing, or having long-term constipation may damage the muscles of the pelvic floor.
Types of Prolapse:
- Bladder Prolapse (Cystocele): A cystocele, or bladder hernia, occurs when the vaginal support of the bladder is weakened. It is characterized by a bulge of the bladder into the vagina. This most commonly occurs from the damage that happens during vaginal delivery.
- Rectal Prolapse (Rectocele): A rectocele occurs when the end of the large intestine (rectum) pushes against the back wall of the vagina. This most commonly occurs from the damage that happens during vaginal delivery. A rectocele also commonly occurs due to chronic constipation and straining.
- Enterocele (small bowel prolapse): An enterocele occurs when the small bowel presses against and moves the upper wall of the vagina. It is a hernia from the top of the vagina that may occur after a hysterectomy. Rectoceles and enteroceles develop if the lower pelvic muscles become damaged by labor, childbirth, a previous pelvic surgery, or muscle weakening as a result of aging.
Votiva is a treatment that works to help provide rejuvenation to both external and internal vaginal tissues without the need for surgery. If pelvic floor weakness or vaginal laxity are caught early, this is an excellent non-surgical treatment for both.
Pelvic floor muscles are just like any other muscles. Exercise can make them stronger. Women can strengthen their pelvic floor through pelvic floor muscle exercises known as Kegel exercises. Your provider at Urology Care P. C. will inform you about and teach you how to do these exercises. Some women have difficulties doing these exercises correctly. If that is the case for you, you may be a good candidate for Votiva or physical therapy.
A pessary is a removable prosthetic device inserted into the vagina to reduce the protrusion of pelvic structures. They are used as a nonsurgical approach to treat pelvic organ prolapse (cystocele, rectocele, uterine prolapse).
A variety of pessaries are available, such as a ring or Gellhorn. You and your provider will determine whether or not you are a candidate for a pessary.
The most common cystocele repairs are done through an incision in the vaginal wall. During this surgery, your surgeon pulls together the loose or torn tissue in the area of the prolapse and strengthens the wall of the vagina. Graft material may be used to further strengthen the repair. This will help prevent the prolapse from recurring.
A rectocele may become large or more obvious when you strain or bear down (for example, during a bowel movement).
Because rectoceles are defects of the pelvic-supporting tissue and not the bowel wall, they are treated most successfully with surgery that repairs the vaginal wall. This surgery pulls together the stretched or torn tissue in the area of prolapse. Surgery will also strengthen the wall of the vagina to prevent prolapse from recurring. Rectoceles are usually repaired through the vagina.
When bladder, vaginal, or rectal prolapse disrupts your quality of life, our team at Urology Care P.C. is here to provide you with high-quality personalized care to ensure your long-term success. Our expert providers will examine you and create a personalized comprehensive treatment plan.
To determine what treatment is best for you, contact us at 520.298.7200 to schedule your appointment.