Bladder prolapse, also known as cystocele, is a common condition that occurs when there’s a loss of support in the connective tissues that support the bladder near the front part of the vagina.

Symptoms

According to Virtua urogynecologist Joseph Maccarone, MD, when bladder prolapse happens, the bladder may protrude through the vagina and outside of the body. However, bladder prolapse may simply present with a feeling of pressure, heaviness or pelvic pain.

Dr. Maccarone notes that many women associate bladder prolapse with incontinence. But he clarified that they’re different, and that often those with bladder prolapse don’t have leakage.

What causes bladder prolapse?

Dr. Maccarone stressed that bladder prolapse is very common. It can occur as a result of vaginal childbirth, but it also happens in women involved in activities that put a strain on the pelvic floor like heavy lifting, gymnastics or skydiving. Prolapse also occurs as a result of other medical conditions that cause strain like chronic cough and lung disease, constipation, hysterectomy, or connective tissue disorders that would result in weaker connective tissues in the pelvic floor.

How is bladder prolapse treated?

There are a variety of surgical and non-surgical treatment options for bladder prolapse. One non-surgical option is physical therapy. Pelvic floor physical therapists specialize in helping tone the muscles around the vagina to prevent the prolapsed bladder from protruding outside the body. Dr. Maccarone said that one to two thirds of women with prolapsed bladder can be helped or cured through physical therapy alone.

The other non-surgical option is the use of a pessary, which is a silicone device that’s placed in the vagina to support the muscles around it. To be used successfully, pessaries must be fitted to the individual by a trained practitioner. Some pessaries can be removed by the individual and some require removal by a healthcare provider. It’s important to work with a qualified clinician to make sure you’re using the pessary correctly.

Surgical options vary depending on the individual’s needs and medical history. Typically, surgery for bladder prolapse involves using either a natural or synthetic tissue to augment or replace connective tissue to support the prolapse, and can be done through the abdomen or vagina.

Bladder prolapse is common and treatable. Make sure your doctor is qualified in female pelvic medicine to help you choose the treatment option that works best for you.