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What is a prolapsed bladder and how does it case incontinence?

A prolapsed bladder happens when a person’s bladder drops from its normal position in the pelvis and pushes on the wall of the vagina. It’s also sometimes known as anterior vaginal prolapse, or cystocele.
 
Bladder prolapse is relatively common in primary care in the UK, 8.4% of women report a vaginal bulge or lump, and after examination prolapse is present in 50% of these cases*.  Although prolapse isn’t a life threatening condition, it can cause pain and discomfort, and may have an effect on your quality of life.
 
Below we have information on the most common bladder prolapse symptoms, along with causes and available treatments. If you suspect you have any of these symptoms, it's important to see a doctor for an accurate diagnosis.

What causes a prolapsed bladder?

The pelvic organs are held in place by the muscles and connective tissues of the pelvic floor. In prolapse, one or more of these organs (including the womb, top of the vagina, bladder or bowel) bulge into the vagina.
 
Bladder prolapse happens when the pelvic floor becomes weakened or too much pressure is put on it. This can happen as a result of:
 
• Childbirth – especially having a large baby/multiple babies or experiencing a long and difficult birth
• Being overweight
• Going through menopause
• Heavy lifting
• Chronic
• Hysterectomy
• Violent coughing and straining
 
Bladder prolapse is more likely with increasing age and in people with conditions like joint hypermobility syndrome, Ehlers-Danlos syndromes and Marfan syndrome. 

Bladder prolapse stages

  • Stage 1 - a small part of the bladder protrudes slightly out of the vagina
  • Stage 2 - the bladder protrudes enough out of the vagina to reach the vaginal opening
  • Stage 3 - the bladder protrudes out of the vaginal opening
  • Stage 4 - the bladder protrudes entirely out of the vagina, usually with other pelvic organs.

Bladder prolapse symptoms

Feeling a bulge or lump in the vagina that you can see or touch is the most common symptom of bladder prolapse. However, there are some other signs and bladder prolapse to look out for:
 
1. and prolapse

Bladder prolapse can affect a woman's ability to pass urine in many ways. Some may need to pass urine more frequently, while others may struggle to pass urine or feel that they cannot completely empty their bladder. Some people experience stress incontinence which means leaking a small amount of urine when you cough, laugh, sneeze, stand up or lift a heavy object. Blood in the urine is not uncommon.
 
2. Feeling bladder prolapse pain or discomfort

You know your body best, so trust your instincts if you think something isn’t quite right. It might be a feeling of heaviness in your lower stomach and genitals, a dragging discomfort, or there’s something coming down into your vagina. Some women describe it as feeling like sitting on a small ball.
 
3. Bladder prolapse pain during sex

Prolapse may also show up as a feeling of discomfort or numbness that you notice during sex. Our article on how to deal with bladder weakness and intimacy has some helpful tips to boost your confidence if you’re struggling.
 
4. No symptoms at all

Despite everything, sometimes prolapse has no symptoms at all. It might be discovered during another medical examination carried out for something else, like a cervical screening. 

Available bladder prolapse treatments

The good news is that prolapsed bladder is treatable. All treatments serve to increase the support for the bladder, helping to hold it in place. One way to help or even prevent prolapse is by practising pelvic floor exercises. 
 
There are also some simple lifestyle changes that can help, such as losing weight (if you’re overweight), not lifting heavy objects to avoid straining, and preventing or treating by eating foods rich in fibre. These interventions help to avoid pushing the bladder downwards against weakened muscle.
 
In some cases, medical treatment is required. This might be in the form of hormone treatment, a vaginal pessary (a small device that, once inserted, holds the bladder in place) or sometimes surgery. How you treat your condition depends on the nature of the prolapse and its impact. 

Bladder prolapse surgery

In the cases where severely prolapsed bladders can't be managed by other means, surgery may be necessary. Your doctor will explain the risks, benefits and potential complications of the available procedures with you before going ahead with bladder prolapse surgery.

During the operation, it's common to have a urinary catheter inserted to your empty bladder for a day after the surgery.

Recovery from bladder prolapse surgery usually takes around six weeks, however, your doctor may recommend reducing or avoiding certain activities that may cause strain on your bladder for up to six months. Recommendations for recovery after surgery, or to prevent bladder prolapse from recurring, may include;

  • Avoiding heavy lifting
  • Daily low-impact exercise, such as walking or swimming
  • Drinking more water and increasing the fibre in your diet to prevent .
  • Regular pelvic floor exercises
  • Getting a lot of rest
 
If you notice a lump in or around your vagina, or are experiencing any of the above symptoms, we recommend you see your GP who will help you decide the best treatment option for you. In the meantime, visit our guides to the bladder and the pelvic floor for more information. Or, if you need protection as a result of prolapse, explore our range of available products on site.

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