A prolapse is a bulging or protrusion of an organ through an opening. This can occur quite often in women where there can be a prolapse of the bladder, uterus, or rectum that can cause the organ to bulge into or actually come out of the vaginal opening.
Prolapse occurs when the supporting structures such as muscles and ligaments are no longer able to hold the organs in place.
A prolapsed bladder is a bulge of the bladder into the vagina. It is officially called a “cystocele” in medical terms. There are some common causes of cystocele including; childbirth, chronic constipation, obesity, pelvic strain, heavy lifting, or violent coughing.
Women who have a cystocele report feeling as if something is coming out of the vagina, a feeling of heaviness or discomfort in the vagina, they report that it feels as if they are “sitting on a ball” and some cystoceles are visible as a lump, bump or bulge coming out of the vagina.
The consequences of a cystocele are; urine leakage, discomfort when urinating, incomplete emptying of the bladder, frequent urge to urinate, and although the bulge can be pushed back into place before intercourse, it may cause painful sexual intercourse or embarrassment. This condition becomes a problem when there is leakage of urine, pain, or when using a pessary, it can no longer be held in place.
Having a cystocele also leaves the sufferer more susceptible to urinary tract infections (UTIs) and chronic lower back pain. Most are left untreated unless there are secondary problems with bladder emptying, chronic infections, or pain. A cystocele can be surgically repaired but it is often not necessary. Surgical interventions include open surgery which is an incision through the abdomen. Minimally invasive surgery, which makes use of several small incisions in the abdomen, laparoscopic surgery where through small incisions, surgical instruments are inserted or robot-assisted laparoscopic surgery, where robotic arms are used and controlled by the surgeon. Remember, all surgery comes with a risk. Consequences may include damage to other organs, infection, or pain.
Some women will opt for the use of a pessary device for the prolapse of the bladder. The pessary is a removable device that is inserted into the vagina to aid in the support of the prolapsed area. It is non-invasive and it is often used in lieu of surgery as there are fewer side effects and risks.
There are very few serious side effects with the use of a pessary but the most common can be vaginal discharge or odor, stinging, and lower stomach pain. Serious complications, which are extremely rare, can include fistula or tissue erosion.
The device can be put in by either a physician or by the woman herself. It will need to be changed periodically (normally every 3-6 months.) The user may initially feel some discomfort when first using a pessary, but that will subside with use. It is important to follow your medical practitioners' instructions when using a pessary device, this includes avoiding douching, vaginal washes, smoking (which can increase coughing which makes the prolapse worse,) and avoiding activities that put pressure on the pelvic muscles such as heavy lifting and squatting.
Kegel exercises (which entail squeezing the same muscles you use to stop urinating and holding that position for 3 seconds) will help to strengthen the pelvic floor muscles and can be performed anytime, anywhere.
HPFY carries a variety of pessary devices at very reasonable costs. This device requires a medical prescription. Ask your physician if a pessary may be appropriate for you!
Author Profile: Laura Castricone, Respiratory Therapist
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