Prolapsed Bladder Explained: Key Causes & Treatments

Under normal circumstances, the pelvic floor muscles and connective tissues hold the urinary bladder in place by acting like a supportive hammock. When these pelvic floor muscles weaken or become stretched, the bladder drops and bulges into the vaginal wall. This is called bladder prolapse.

Bladder prolapse (cystocele) is the most common type of pelvic organ prolapse. Other pelvic organs can also prolapse (drop out of their normal position and bulge into the vaginal canal). This includes the uterus (uterine prolapse) or bowel (enterocele, rectocele).

Mild or moderate prolapse can cause symptoms such as increased urinary frequency and urinary incontinence. Incontinence is leaking urine or losing control of the bladder. In severe cases, bladder prolapse can cause the bladder tissue to be seen or felt at the opening of the vagina or even drop through the vaginal opening. Continue reading to learn more about the causes, signs, and treatments for a prolapsed bladder.

What is a Prolapsed Bladder?

A prolapsed bladder is a condition in which bladder tissue bulges through the wall of the vagina or vaginal opening.

Common causes of prolapsed bladder include vaginal childbirth and chronic constipation. Experts at the National Institute of Diabetes and Digestive and Kidney Diseases estimate that approximately half of all women who have given birth have some degree of pelvic organ prolapse.

Other names for a prolapsed bladder include:

Cystocele
Anterior vaginal prolapse
Herniated bladder
Fallen bladder
Dropped bladder
Sagging bladder

What Are The Symptoms of a Bladder Prolapse?

Prolapsed bladder (cystocele) symptoms include:

Seeing or feeling a bulge at the vaginal opening.
Fullness or heaviness in the pelvic area. This sensation can get worse with coughing, lifting heavy objects, or prolonged standing.
Pain or discomfort in the vagina, groin, pelvis, lower abdomen, or lower back.
Frequent urination (needing to go to the bathroom often).
Incontinence (leaking urine).
Hesitancy (difficulty starting urination).
Slow urine stream.
Difficulty emptying the bladder.
Frequent urinary tract infections (UTIs).
Difficulty inserting menstrual products such as tampons or menstrual cups.
Pain during sexual intercourse.

Causes of Bladder Prolapse

The most common cause of bladder prolapse (cystocele) is pregnancy and childbirth. Vaginal childbirth weakens the pelvic floor muscles and tissues. Women who have multiple pregnancies, vaginal deliveries, or prolonged and difficult childbirth are at greater risk of developing bladder prolapse symptoms.

Other causes of a prolapsed bladder include:

Heavy lifting.
Chronic constipation and straining.
Lung conditions that cause chronic cough.
Obesity (having a body mass index, BMI, greater than 30) leading to increased strain on the pelvic floor.
Menopause due to reduced estrogen production (estrogen hormone supports pelvic floor muscles).
Prior pelvic surgery, such as hysterectomy.

Risk factors for prolapsed bladder include a family history of cystocele.

Diagnosing Bladder Prolapse

You should seek medical care if you have any cystocele symptoms (see above). Getting a proper diagnosis and having bladder prolapse treated can prevent serious complications like urinary retention.

Exams and Tests for Diagnosis

Healthcare providers can diagnose bladder prolapse based on your symptoms, medical history, pelvic exam (internal examination), and diagnostic tests. You may need to see a specialist, such as a urologist, gynecologist, or urogynecologist. They may order tests such as:

Urine test (urinalysis): This can help rule out other causes of your symptoms, such as a UTI.
Voiding cystourethrogram (VCUG): This is an imaging test done using X-rays and a special dye that allows doctors to see the urinary tract and bladder.
Urodynamics: These tests check bladder function (ability to hold and release urine).
Cystoscopy: This imaging test is done using a thin, flexible instrument called a cystoscope that has a light and camera attached to its tip. It is inserted through the urethra into the bladder and allows healthcare providers to look inside the bladder and see things like stones, tumors, blockages or other problems in the urinary tract.

Treatment Options for Prolapsed Bladder

Bladder prolapse treatment depends on the severity of the condition. A prolapsed bladder that doesn’t bother you may not require treatment, while more severe instances may require surgical and nonsurgical treatments.

Home Care and Lifestyle Adjustments

Mild cystocele can usually be managed with lifestyle changes, such as:

Avoiding heavy lifting.
Avoiding constipation and straining.
Maintaining a healthy weight.
Doing Kegel exercises (these are pelvic floor exercises that help to strengthen the muscles and tissues of the pelvic floor and prevent worsening of bladder prolapse).

Nonsurgical Treatments for Bladder Prolapse

Mild or moderate prolapse may benefit from treatments such as:

Hormone replacement therapy or estrogen replacement therapy.
A vaginal pessary device that helps to hold the bladder in place.

Surgical Interventions

Surgical treatment options for severe prolapse include a procedure called anterior colporrhaphy. During this procedure, the surgeon moves the bladder back into its normal position and tightens the muscles to hold it in place. A surgical mesh may be used to provide extra support. It is a minimally invasive surgery and most people can go home the same day. Full recovery can take a few months, however.

People who have pelvic organ prolapse involving other organs (uterine prolapse, rectal prolapse) may need more extensive surgery.

At What Point Does a Prolapse Require Surgery?

Doctors usually recommend surgery for prolapse when it is causing bothersome symptoms or in severe cases when there is a risk of complications. In some cases, a cystocele can impair your bladder from completely emptying, which can lead to damage to the organs upstream in your urinary tract (the ureters and kidneys).

You should consider surgery if your bladder prolapse symptoms are affecting your quality of life. However, keep in mind that pelvic organ prolapse can recur after surgery. Also, surgery on your pelvis can increase the risk of prolapse in the future.

Is It Safe to Live With a Prolapsed Bladder?

A bladder prolapse (cystocele) is not life-threatening. However, left untreated, it can affect your quality of life by causing significant symptoms. There is also a risk of complications such as urinary retention, which can lead to kidney infection or damage. This can occur if the prolapsed bladder presses upon the urethra (the tube through which urine leaves the body) and prevents emptying of the bladder.

Preventing Bladder Prolapse

Pelvic Floor Exercises

Pelvic floor exercises or Kegel exercises are the most commonly prescribed bladder prolapse treatments. They help strengthen the muscles that support the uterus, bladder, and bowels. Kegels can help with bladder prolapse symptoms, especially in people with mild bladder prolapse.

You can learn to do these exercises yourself or from a pelvic floor physiotherapist. A short course of bladder prolapse physical therapy can help you learn the correct technique for Kegel exercises.

Once you know how to do pelvic floor exercises, you can do them any time of the day while sitting or lying down, including while working at your desk, driving, eating meals, or watching television.

To do a Kegel exercise, squeeze the muscles in your pelvic floor as if you are trying to stop urinating. Hold the muscle tight for 5-10 seconds and do 10 repetitions 3 times a day.

Long-Term Health Strategies

Other strategies that can help prevent and treat bladder prolapse include:

Maintaining a healthy body weight.
Eating a high-fiber diet to prevent constipation (infrequent bowel movements and straining).
Taking prescribed treatment for lung conditions to prevent chronic coughing.

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FAQ on Bladder and Prolapse

Can I Fix a Prolapse Myself?

You cannot fix a prolapse yourself. It’s important to see a healthcare provider and receive a proper diagnosis. If you have mild prolapse, your provider may recommend home remedies such as strengthening the pelvic floor muscles with Kegels exercises.

Is It Safe To Live With a Prolapsed Bladder?

A prolapsed bladder is not life-threatening. However, it can cause serious complications by pushing up on your urethra and preventing the bladder from emptying. This is called urinary retention, and it can cause kidney damage.

Is It Okay To Leave a Prolapse Untreated?

Whether you can leave a prolapse untreated depends on the severity. If you have mild pelvic organ prolapse that does not affect your quality of life, your healthcare provider may opt for conservative management. However, in severe cases, the symptoms can become bothersome, and treatment may be necessary to prevent complications.

How Do You Fix a Prolapsed Bladder?

Mild bladder prolapse can be managed with pelvic floor exercises and lifestyle changes (avoiding heavy lifting, treating chronic cough, maintaining a healthy weight, and avoiding constipation).

Mild to moderate bladder prolapse may require treatment with hormone replacement therapy or a vaginal pessary. More severe cases may require surgical treatment, such as an anterior colporrhaphy procedure.