Situated in your pelvis is the balloon-like organ meant for storing urine and known as the bladder. As your bladder fills up with urine, pressure is created and it is this pressure that you sense as an urge to urinate. As you urinate, the urine travels from your bladder to the urethra and out of your body, and the pressure or urge is relieved.
In women, the bladder is supported in part by the frontal wall of the vagina. The wall may become less sturdy with age. Childbirth is also hard on this part of the body and may cause damage, too. The vaginal wall may weaken so much that the bladder is no longer held in place so that it descends into the woman's vagina. This is what is known as a prolapsed bladder.
A prolapsed bladder may cause a variety of urinary problems, including stress incontinence (urine leakage as a response to coughing, sneezing, and exertion) and discomfort. Other names for prolapsed bladder are fallen bladder or cystocele. Physicians categorize prolapsed bladders into four grades that signify the degree of prolapse, or how far the bladder falls into the vagina.
*Grade 1—the mildest category of prolapse in which only a small part of the bladder dips into the vagina.
*Grade 2—moderate prolapse in which the bladder is far enough into the vagina to reach the vaginal entrance.
*Grade 3—severe prolapse in which the bladder is sticking out of the body through the opening of the vagina.
*Grade 4—complete prolapse in which the bladder has fallen out of the vagina altogether. Other prolapsed organs often accompany this degree of bladder prolapse (enterocele, rectocele, uterine prolapse).
Prolapsed bladders are common in menopausal women. Estrogen helps women to maintain the integrity of their vaginal muscles. Menopause brings an end to estrogen production so that the muscles begin to deteriorate. Here are some other factors that can contribute to bladder prolapse:
*Childbirth—bearing children stresses the tissues and muscles of the vagina, which is the bladder's supportive wall.
*Menopause—estrogen, the hormone that keeps vaginal muscles toned, stops being produced after menopause.
*Exertion—activities like picking up heavy objects, chronic cough, straining because of chronic constipation or during bowel movements contribute to a weakening of the pelvic floor muscles.
A woman may first notice the prolapse when she senses a ball-like protrusion in her vagina. Other symptoms include:
*Tissue that protrudes from the vagina which may feel tender or even bleed
*Pain or discomfort in the pelvic region
*Difficulty with urination
*A sensation of incomplete emptying of the bladder after urination
*Leaking urine during coughing, sneezing, lifting objects (stress incontinence)
*The frequency of bladder infections increases
*Sex is painful
*Lower back pain
A grade 1 prolapse may not generate any symptoms at all.