Women's Health

Prolapsed Bladder

When to Seek Medical Care for a Prolapsed Bladder

Any woman who notices symptoms of a prolapsed bladder should contact her doctor. A prolapsed bladder is commonly associated with prolapses of other organs within a woman’s pelvis. Thus, timely medical care is recommended to evaluate for and to prevent problematic symptoms and complications caused by weakening tissue and muscle in the vagina. Prolapsed organs cannot heal themselves, and most worsen over time. Several treatments are available to correct a prolapsed bladder.

Exams and Tests for a Prolapsed Bladder

An exam of the female genitalia and pelvis, known as a pelvic exam, is required in order to diagnose a prolapsed bladder. A bladder that has entered the vagina confirms the diagnosis.

For less obvious cases, the doctor may use a voiding cystourethrogram to help with the diagnosis. A voiding cystourethrogram is a series of X-rays that are taken during urination. These help the doctor determine the shape of the bladder and the cause of urinary difficulty. The doctor may also test or take X-rays of different parts of the abdomen to rule out other possible causes of discomfort or urinary difficulty.

After diagnosis, the doctor may test the nerves, muscles, and the intensity of the urine stream to help decide what type of treatment is appropriate.

A test called urodynamics or video urodynamics may be performed at the doctor's discretion. These tests are sometimes referred to as "EKGs of the bladder". Urodynamics measures pressure and volume relationships in the bladder and may be crucial in the decision making of the urologist.

Cystoscopy (looking into the bladder with a scope) may also be performed to identify treatment options. This test is an outpatient office procedure that is sometimes performed on a television screen so the person can see what the urologist sees. Cystoscopy has little risk and is tolerable for the vast majority of people.

Prolapsed Bladder Treatment

A mild (grade 1) prolapsed bladder that produces no pain or discomfort usually requires no medical or surgical treatment. The doctor may recommend that a woman with a grade 1 prolapsed bladder should avoid heavy lifting or straining, although there is little evidence to support this recommendation.

For cases that are more serious, the doctor takes into account various factors, such as the woman’s age, general health, treatment preference, and the severity of the prolapsed bladder to determine which treatment is appropriate.

• Nonsurgical treatments for a prolapsed bladder include the following:
  
  • Pessary: A pessary is a device that is placed within the vagina to hold the bladder in place. Pessaries must be removed and cleaned at regular intervals to prevent infection. Some pessaries are designed to allow the woman to do this herself. A doctor must remove and clean other types. Estrogen cream is commonly used along with a pessary to help prevent infection and vaginal wall erosion. Some women find that pessaries are uncomfortable or that they easily fall out.
    
  • Estrogen replacement therapy: Many women with prolapsed bladders may benefit from this therapy. Estrogen helps strengthen and maintain muscles in the vagina.