Fallen Bladder (Cystocele)-Abnormal Position of the Bladder

Fallen bladder is clinically known as cystocele or bladder prolapse, which occurs in women. It is a condition wherein the bladder-the urinary system structure that stores urine-moves out of its position and droops into the vagina. This can happen when the tissue structures between the bladder and the vagina weakens causing it to drop into the vagina.

The bladder is located or found in the pelvis. It is a balloon-shaped, hollow muscular organ that stores urine. During urination, the bladder muscles contract to push urine out of the bladder.

The most common cause of the condition is too much muscle straining during childbirth. During childbirth, the mother contracts her abdominal muscles causing the structures in the abdomen like the intestines to move down, thereby, pushing the bladder downwards as well. Fallen bladder can also occur as a result of too much straining during bowel movements or lifting of heavy objects.

Estrogen, a hormone produced by the ovaries, help keep the muscles around the vagina strong. However, during women's menopausal years-that is, when they stop having menstruations-estrogen production stops. This can cause the muscles near the vagina grow weak over time.

A fallen bladder can cause discomfort and could cause bladder emptying problems. Two common problems that arise when fallen bladder occurs are unwanted leakage of urine and incomplete bladder emptying.

Dropping of the bladder may also stretch the opening into the urethra-the last portion of the urinary tract where urine from the bladder passes to the outside of the body. This can cause urine to leak when the woman laughs, coughs, sneezes, or attempt to carry a heavy object.

Other symptoms of fallen bladder may include pelvic pain and unusual feeling of bulging within the vagina.

If the bladder drops just a short way into the vagina, this is called mild fallen bladder, mild cystocele, or grade 1. This may not require special medical treatment. However, heavy lifting or too much straining should be avoided as this could make the condition worse. If symptoms make the woman uncomfortable, the doctor may recommend the use of a pessary, which is a small device that can be placed within the vagina to help hold the bladder in place. The pessary should be regularly removed as this can be a potential cause of infection.

If constipation is a problem, including fibers in the diet might help. The doctor may recommend a laxative to help relieve constipation. However, the use of laxative is not advised to be used for long periods as this can cause serious side effects. The doctor would likely recommend the use of laxative for a limited time. You should follow the doctor's orders.

When the bladder drops far enough to reach the vaginal opening but not bulge out, it is classified as severe or grade 2-cystocele. An advanced cystocele or grade 3 is the classification given when the bladder protrudes out of the opening of the vagina. The doctor may recommend surgery for grades 2 and 3 cystoceles. The primary goal of surgery is to move the bladder back into a more normal position and keep it there.

Sources:

Cystocele (Fallen Bladder). National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC).

Laxative Abuse. University of Iowa Hospitals and Clinics.