Facts You Should Know About Prolapsed Bladder
Line drawing indicating the relationship between the kidney, ureters, and bladder
The bladder is a hollow organ in the pelvis that stores urine. The pressure created when the bladder fills with urine is what causes the urge to urinate. During urination, the urine travels from the bladder through the urethra out of the body.
In women, the front wall of the vagina supports the bladder. This wall can weaken or loosen with age. Pregnancy and childbirth as well as pelvic surgery such as a hysterectomy can weaken this part of the vaginal wall, as well. If it deteriorates enough, the bladder can prolapse, meaning it is no longer supported adequately and descends into the vagina. This may trigger problems such as urinary difficulties, discomfort, and stress incontinence (urine leakage caused by sneezing, coughing, exertion, etc.). Other organs can also prolapse into the vagina, including the uterus, the small intestine, and the rectum (rectocele).
Prolapsed bladders (also called cystoceles or fallen bladders) are separated into four grades based on how far the bladder droops into the vagina.
- Grade 1 (mild): Only a small portion of the bladder droops into the vagina.
- Grade 2 (moderate): The bladder droops enough to be able to reach the opening of the vagina.
- Grade 3 (severe): The bladder protrudes from the body through the vaginal opening.
- Grade 4 (complete): The entire bladder protrudes completely outside the vagina; usually associated with other forms of pelvic organ prolapse (uterine prolapse, rectocele, enterocele).
Prolapsed bladders are commonly associated with menopause. Prior to menopause, the ovaries produce the hormone called estrogen, which helps keep the vaginal tissues strong and healthy. After menopause, the tissues that support the vagina weaken.
Prolapsed bladder is common -- approximately 40% of women over 50 years of age will have pelvic organ prolapse, and approximately 10% will require surgery for pelvic organ prolapse and urinary incontinence (leakage of urine).