Bladder prolapse can cause discomfort and changes in how you urinate, but it’s a common condition with a range of treatment options. Knowing the symptoms can help you decide when to seek care.
If you’ve noticed pelvic pressure, a feeling of heaviness or bulging, or changes in how you urinate, it may be hard to know what’s causing your symptoms — or how to talk about them with your doctor.
These symptoms can be uncomfortable — and sometimes hard to talk about — but they are also common signs of pelvic organ prolapse. One type is often called bladder prolapse because it involves the bladder. The medical term is anterior vaginal prolapse, also known as cystocele.
Anterior vaginal prolapse happens when the pelvic floor muscles, supportive ligaments and other connective tissues between the bladder and vagina stretch or weaken. As a result, the bladder can drop into the front wall of the vagina, causing pressure, discomfort and changes in urination.
“The good news is that it’s a benign condition,” said Dr. Ukpebo Omosigho, a urogynecologist who specializes in pelvic organ prolapse with the Vanderbilt Center for Women’s Health. “And you can get help for this condition.”
What anterior vaginal prolapse feels like
It can be hard to describe the exact sensation of anterior vaginal prolapse. Many women describe it as feeling some pressure, bulging or the sensation that something is coming out of the vagina, according to Omosigho.
In a mild case, where just the edge of the bladder hangs into the vagina, you might not notice any symptoms at all. Or you may experience some discomfort or pressure in your abdominal area. You might leak some urine or need to pee more often.
In more severe cases, where the anterior vaginal wall protrudes through the vaginal opening, you may have more pressure or pain in your vaginal area. It’s also pretty common to have trouble urinating normally. You might even develop recurrent urinary tract infections because it’s hard to fully empty your bladder.
The most likely cause
Pelvic organ prolapse can happen in different areas of the pelvis. Anterior vaginal prolapse, the most common type, involves the bladder and front wall of the vagina. Prolapse can also involve the uterus and cervix, the top of the vagina after a hysterectomy or the back wall of the vagina near the rectum. A pelvic floor specialist can determine which type of prolapse is present.
The number one cause of anterior vaginal prolapse is childbirth. Pregnancy and childbirth, especially vaginal deliveries, can put stress on the muscles and tissues that help hold the bladder in place.
Other possible risk factors for prolapse include:
- Lifting heavy weights
- Chronic cough
- Constipation
- Obesity
- Menopause and declining estrogen levels
- Previous pelvic surgery
Prolapse also doesn’t usually develop right away. The likelihood goes up with age, most notably in women who’ve experienced pregnancy and childbirth.
“It develops gradually, over time,” Omosigho explained.
However, many women put off seeing their doctor about it, usually because they’re busy juggling many other concerns and responsibilities, she adds. “Only a small number of women notice it and come in right away to be evaluated. The majority of women have been dealing with it for an extended period of time before they come in to be seen,” she said.
An array of treatment options
Treatment for anterior vaginal prolapse depends on how much the condition is affecting your daily life and whether it is interfering with urination. “It’s benign, so we have the option of watching and seeing how symptoms progress,” Omosigho said.
If symptoms become bothersome or begin to interfere with daily life, nonsurgical treatment options may include:
- Kegel exercises to help strengthen the pelvic floor muscles
- Pelvic floor physical therapy
- Using a pessary, which is a small, flexible silicone disk that’s inserted into the vagina to provide support
- Estrogen replacement therapy.
Surgery is also an option for some women, according to Omosigho. A surgeon can use a patient’s own tissues to suspend the area or in some cases apply a piece of mesh for additional support.
When to see your health care provider
If you’ve noticed any discomfort in your pelvic area, have trouble urinating or you have any concerns that something isn’t right, contact your gynecologist.
“Pelvic organ prolapse can have a significant impact on your quality of life, but there are things that we can do about it,” Omosigho said. “You don’t have to just live with it if you don’t want to.”
Omosigho added that she especially wants to encourage women not to give up on the activities that keep them healthy overall, like exercising and lifting weights.
“You don’t want prolapse to dictate your cardiovascular health,” Omosigho said. “We can definitely get you to a place where you’re comfortable in the gym again.”
Back to a fuller life
As women’s health and urogynecology experts, the Urogynecology and Pelvic Reconstructive Surgery team at Vanderbilt offers personalized care for bladder-related symptoms and conditions. These experts are here to offer treatment that lets you live a a fuller life. Call 615-343-5700 for an appointment.
