Bladder is generally a hollow organ which is located within the pelvis & stores urine. Pressure is created when bladder fills up with urine & which eventually causes the urge to urinate. Urine typically travels from bladder & out through the urethra during urination. The front wall of the vagina normally supports the bladder in women. However, this wall can loosen or weaken with age. Significant amount of bodily stress like as in childbirth is often found to damage this part of the vaginal wall. Bladder can at times collapse if it deteriorates. This means that bladder is no longer supported & will eventually descend into the vagina. This condition can also trigger problems like discomfort, difficulty in urination & stress incontinence which is leakage of urine caused by exertion, coughing & sneezing.
Prolapsed Bladders are also called Fallen Bladders or Cystoceles. These are separated in four grades that are based upon how far the bladder droops into the vagina.
Prolapsed bladders are most commonly associated with menopause. Women’s bodies were creating hormone estrogen prior to menopause which eventually helped keep muscles located in & around vagina stronger. However, after menopause women’s bodies stop creating as much estrogen & therefore these muscles tend to weaken as a result.
Factors listed below are commonly associated with causing prolapsed bladder in women.
First symptom which women with prolapsed bladder usually notice is presence of tissue in vagina which women generally describe as something feeling like a ball. Other symptoms of prolapsed bladder in women include the following.
Some women with mild grade 1 prolapsed bladder may not experience or notice any symptoms of prolapsed bladder.
Women noticing symptoms of prolapsed bladder should immediately see a doctor. Prolapsed bladder is also commonly associated with prolapse of other organs within the pelvic region of women. Timely medical care is therefore recommended so as to evaluate & prevent problematic symptoms & complications arising out of weakening of muscle & tissue within the vagina. Moreover, prolapsed organs do not heal by themselves & will most often worsen with time. Women should seek timely professional help as several treatments are available for correcting prolapsed bladder.
Examination of pelvis & female genitalia, which is known as a pelvic exam, is required so as to diagnose prolapsed bladder. A bladder which has entered the vagina however confirms diagnosis of prolapsed bladder. Doctors may however use Voiding Cystourethrogram in order to help with diagnosis for less obvious cases of prolapsed bladder. Voiding cystourethrogram is a series of X-rays which are taken during urination. These eventually help doctors determine shape of bladder & the cause of difficulty in urination. Doctors may also conduct tests or take X-rays of different regions of the abdomen in order to rule out other possible causes of discomfort & difficulty in urination. Doctors may subsequently test muscles, nerves & intensity of urine stream so as to help decide which type of treatment is most appropriate after diagnosing prolapsed bladder. Urodynamics or Video Urodynamics is a test which may be performed at the discretion of doctors. These set of tests are sometimes referred to as ‘EKGs of Bladder’. Urodynamics test measures pressure & volume relationship in bladder & might often prove to be crucial in the decision making capacity of the urologist. Cystoscopy, which is looking inside the bladder with a scope, is also often performed so as to identify treatment options. This test is generally an outpatient procedure which is sometimes performed on television screens so that the patient can also see what the urologist is seeing. Moreover, cystoscopy has little risks & is most often tolerable by a vast majority of women.
Mild Grade 1 Prolapsed Bladder which produces no discomfort or pain usually requires no type of medical or surgical treatment procedures. Even though there is no substantial evidence to support this recommendation, doctors often recommend women with grade 1 prolapsed bladder to avoid lifting heavy loads or straining. Doctors take into account various factors like general health, woman’s age, treatment preference & severity of prolapsed bladder so as to determine which treatment procedure is appropriate for cases which are more serious in nature.
Doctors may recommend activity modification like avoiding heavy straining or lifting for mild to moderate cases of prolapsed bladder in women. They may also find it useful to recommend Kegel exercises as they are helpful in tightening muscles of the pelvic floor. Kegel exercises are ideal to treat mild to moderate prolapsed bladder cases or as supplement for other treatments for prolapsed bladder which are more serious in nature.
Estrogen replacement therapy is most often used for prolapsed bladder so as to help women’s body strengthen tissues in & around vagina. However, estrogen replacement therapy is not useful for everyone, especially for women with certain types of cancer. Women’s bodies are found to stop creating natural hormone estrogen after menopause & therefore muscles of vagina may eventually weaken as a result. Estrogen may successfully be prescribed in an attempt to reverse prolapsed bladder symptoms like incontinence & vaginal weakening in mild cases of prolapsed bladder. Moreover, estrogen replacement therapy may also be used along with other types of prolapsed bladder treatment for more severe degrees of prolapsed bladder. Estrogen can also be orally administered as pill or typically as cream or a patch. Estrogen cream has very little systemic absorption & therefore has a local potent effect wherever it is applied. Topical administration of estrogen has lesser risk than oral preparations. Application of estrogen to anterior regions of vagina & urethra may prove very helpful in alleviating urinary symptoms including frequency & urgency, even when the patient is facing the prospect of prolapsed bladder.
Sever cases of prolapsed bladders which cannot be managed with pessary usually need surgery so as to correct them. Surgical intervention for prolapsed bladder is usually performed through the vagina with a goal to secure bladder in its original correct position. Bladder is typically repaired through an incision in the vaginal wall. Prolapsed area is subsequently closed & vaginal wall strengthened. Prolapsed bladder surgery can be performed while the patient is under influence of local, regional or general anesthesia, while the choice will depend upon the type of procedure involved. Women undergoing smaller surgeries can also go back home on the same day of prolapsed bladder surgery. There also are various materials which have been successfully used to strengthen pelvic weakness which is normally associated with prolapsed bladder. Risks of placing mesh through vagina in order to repair pelvic organ prolapsed may however far outweigh the benefits according to FDA. Nevertheless, use of mesh may however be appropriate in many situations of prolapsed bladder. Surgeons therefore should clearly explain details to patients regarding risks, benefits & potential complications of materials involved & should also explain about the surgical intervention before proceeding with surgery. Most women after surgery can expect to return to normal level of activity after about six weeks of time. However, surgeons also recommend that women undergoing prolapsed bladder surgery reduce or entirely eliminate activities which cause straining for up to six months of time.
Physical therapies like Biofeedback & Electrical Stimulation may also be used in cases of prolapsed bladder so as to help strengthen muscles within the pelvic region.
Women undergoing treatment for prolapsed bladder should schedule follow-up visits with doctors so as to evaluate progress. Moreover, pessaries also need to be removed & cleaned at regular intervals in order to prevent complications.
A high fiber diet & daily intake of fluids will reduce risk of developing constipation in women & will therefore eventually help them to prevent suffering from a prolapsed bladder. Long as it is possible, straining during bowel movements should be carefully avoided. Moreover, women with long-term constipation should sensibly seek medical attention so as to lessen chances of developing a prolapsed bladder. Lifting heavy loads, which is also associated with prolapsed bladder, should be avoided whenever possible. Since obesity is also a factor creating risk of developing prolapsed bladder; weight control can go a long way in helping prevent this medical condition from developing.
Good news is that prolapsed bladder is rarely a life-threatening condition. Moreover, most cases which are mild in nature can be effectively treated without going in for any surgical intervention, while most severe prolapsed bladder cases can completely be corrected with prolapsed bladder surgery.
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