Conditions, Urinary Incontinence

What is Bladder Prolapse (and how to know if you have it)

If you suffer from incontinence there is a chance that you have a prolapsed bladder. This is also known as a dropped bladder, cystocele or a bladder hernia.

This can (and should be) diagnosed by your doctor but there is also an easy way to check for it at home.




What is Bladder Prolapse?

A prolapsed bladder is the bulging (or ‘dropping’) of the bladder into the vagina. It is a saclike protrusion (hernia) of bladder tissue that has moved further down where it doesn’t belong.

The bladder bulges into the vagina near the vaginal opening, or even out of the opening.

What causes Bladder Prolapse?

Bladder prolapse occurs when the muscles and tissue between the bladder and the vagina stretch and weaken.

This often occurs with ageing as muscle tone decreases or with damage to the muscles and/or tissues.

Childbirth can also play a role. As the baby moves down the vaginal canal during birth its head lodges underneath the bladder neck. It should rest there only briefly but sometimes during prolonged birth it may rest there for longer periods of time. This could pose stress on the ligaments that support the bladder neck and weaken them. This may also increase with subsequent births.

Other factors that may weaken muscle tone and/or damage tissues:

  • Straining when moving the bowels
  • Constipation
  • Chronic coughing
  • Obesity
  • Heavy lifting

What are the Symptoms of Bladder Prolapse?

  • Incontinence: Stress, Overflow, urgency
  • Vaginal bulge
  • Incomplete urination
  • Pelvic heaviness
  • Difficulty starting urination

How does Bladder Prolapse cause Incontinence?

Think of a hernia as a little sac hanging from your bladder. This makes it easy to understand that this little sac can hold urine that is not expelled like the rest of the urine in the bladder during voiding.

The weight of the urine in the hernia may tug on the bladder neck and under this strain the bladder neck may not be able to generate its normal closing pressure.

Now when you laugh, sneeze or run a ‘shock wave’ is sent to the bladder neck. Normally, this shouldn’t affect the bladder neck but if it has been weakened by childbirth and the pressure of a hernia it may open up and you leak.

How to tell if you have Bladder Prolapse

  • Put your finger into your vagina and feel the front wall (side of your bladder and belly)
  • Purposely cough or strain
  • If something comes down and touches your fingers near the opening of the vagina you may have bladder prolapse
  • Another indicator is how you void. If you wait a moment after voiding and another little squirt of urine comes out you may have bladder prolapse.

Have it confirmed by your doctor.

There are three grades of severity, depending on how far the bladder has dropped into the vagina:

  • grade 1—mild, when the bladder drops only a short way into the vagina
  • grade 2—moderate, when the bladder drops far enough to reach the opening of the vagina
  • grade 3—most advanced, when the bladder bulges out through the opening of the vagina

How is Bladder Prolapse Treated?

The conventional treatment depends on the severity of the prolapse.

  • Common treatments include:
  • Kegel Exercises
  • Losing weight
  • Avoid constipation and strain
  • Vaginal pessaries
  • Surgery
  • Mesh implants

If you have been following my Blog in the past, you may be aware that I’m a fan of getting to the root issues and finding the most natural and least risky solutions.

Therefore I see some problems with some of the treatment options.

Vaginal pessaries: although probably preferable to surgery, these are simply designed to keep the prolapse in place and do not get rid of the root problem. Inserting anything long-term into the vagina could pose an increased risk for infections, including urinary tract infections.

Surgery: Surgery has risks for obvious reasons. For someone who still wants children, this isn’t usually advised as the prolapse can recur.

Mesh implants: These I’m most wary off as I have seen several reports of women suffering severe side-effects from this procedure. Make sure you inform yourself thoroughly before agreeing to this procedure. The Sling the Mesh Campaign has some great information.

What to Do

If you are obese and/or suffer from constipation you should consider working on improving these by changing your diet (you can check out my guidelines for a general health-promoting diet).

I’d recommend to start with pelvic floor exercises. However, I’d specifically recommend using weights for this such as outlined in this post.

Doing kegels without resistance is like flexing your arms without weights to build arm muscles – probably ineffective.

Yoga could also be a valuable addition.

Whole body strength training may also help to strengthen the pelvic floor.

I personally have slight bladder prolapse and have just started a yoni egg practice – I will let you know how that goes.

Are you suffering from bladder prolapse? What have you done about it? Let me know in the comments!



Pin it for later:

Sources

NIH Cystocele (Prolapsed Bladder) March 2014 https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women/cystocele-prolapsed-bladder

NHS Choices Pelvic organ prolapse – Treatment May 2015 http://www.nhs.uk/Conditions/Prolapse-of-the-uterus/Pages/Treatment.aspx

Gillespie, Larrian You Don’t Have to Live With Cystitis (New York: Avion Books, 1996)

 

 

 

 

 

 

 

 

 

 

 

4 Comments

  • Reply

    Laura

    August 28, 2017

    Although not diagnosed, I know I have bladder prolapse — bladder protrusion, incomplete voiding. After my third child was born 35 years ago, I was experiencing bladder leakage, so I began a regular exercise program that included kegels. My pelvic floor muscles improved, the leakage stopped, and I had two more children. I’ve kept up the aerobic exercise and added yoga, and the only issues I have now are the two mentioned, which didn’t start until a number of years after my last child was born in 1991. Should I mention the prolapse to my doctor? I don’t want the surgery or the mesh, and I’m not sure that a pessary is the solution either. Would regular practice of kegels help these conditions? I’m 65 years old, work out 6 days a week, am eating a lower carb diet now, and am in otherwise good health.

    • Reply

      Layla

      August 29, 2017

      Hi Laura, thanks for sharing your experience. I cannot advice you on how to proceed with your doctor, this decision is up to you. Personally, if Kegels had worked for me in the past I would stick with it as I’d find the other options too risky. I also cannot promise that kegels will definitely help these problems but they are widely thought to be beneficial in any case and there is no reason why you couldn’t try it. For more effective kegels I’d suggest to add resistance, for example a yoni egg, that is inserted into the vagina and acts like a weight for the muscles. If you type in Layla Martin or Kim Anami into google/youtube they both give some great tips on ‘vaginal weightlifting’ (Kim Anami can lift Surfboards with her vagina, so she should certainly know what she is talking about). I’m working on this myself. I hope you can get it sorted!

      • Reply

        Laura

        August 29, 2017

        Thanks so much for your prompt reply, Layla! I will look into getting a yoni egg! I neglected to mention that I struggled with interstitial cystitis for about 14 years. It was really severe at first but moderated when I avoided acidic foods (particularly citrus), so I was able to control it without medication. It would usually flare up when I was stresssed. All during this time I was dealing with hormonal issues (hot flashes, poor sleep). Even with progesterone and estrogen cream use, I couldn’t get complete relief. I finally found a doctor who started me on OTC pregnenolone and DHEA. My hot flashes and sleeplessness are gone, as is any reaction to acidy foods. Even lemon water or apple cider vinegar would have me reacting in the past, but that’s all gone. I also started taking an herbal preparation with Angelica in it, which has eliminated any nightly trips to the bathroom. I’m so grateful to get this problem solved without the use of nasty medications that only cause more issues! Again thanks for the advice about the kegel “machine”!

        • Reply

          Layla

          August 31, 2017

          Interesting to hear that you’ve had relief from the hormonal approach. I have come across DHEA for IC before and am gonna look into this further. Thanks for sharing!

Leave a Reply