Prolapsed bladder symptoms

Prolapsed bladder (also called a bladder prolapse or cystocoele) occurs when a woman’s pelvic floor muscles, which support the wall between the bladder and vagina, are weakened. The term ‘prolapse’ means ‘to fall out of place’. 

Some women who have a bladder prolapse don’t experience any symptoms that trouble them. Others may experience the following symptoms:

• the sensation of a vaginal lump causing pressure or a ‘dragging’ feeling 
• a lump that bulges out of the vagina
• trouble urinating or a feeling that the bladder has not been fully emptied
• urinary incontinence (leaking urine)
• problems or pain when having sexual intercourse

Prolapsed bladder causes

A prolapsed bladder is common, particularly among women who have had a vaginal birth. The more vaginal births they have had, the greater the chance the woman will experience a prolapsed bladder. This is particularly so if the baby was delivered with forceps. Other causes of prolapsed bladder include:

• menopause, which decreases oestrogen, a hormone that tones and maintains the strength of the pelvic floor
• ageing, which relaxes the pelvic muscles and ligaments which hold up the bladder
• regular straining during bowel movements
• chronic or constant coughing over a long period of time
• being overweight or obese
• repeated, heavy lifting
• a genetically weak pelvic floor
• previous pelvic organ prolapse surgery

Prolapsed bladder diagnosis

A doctor will diagnose a prolapsed bladder by doing an internal examination and taking your medical history. This will help the doctor find out how severe the prolapse is, the condition of your pelvic floor muscles and whether other internal organs such as your bowel or uterus have also prolapsed.

You might have other tests such as an ultrasound, bladder function test, or urine test.

Prolapsed bladder treatment

Many women with a prolapsed bladder don’t experience any symptoms and don’t need treatment. However, this condition doesn’t go away and can get worse over time.

Treatment usually depends on the severity of the prolapse.

Mild prolapse

This can be treated with:

• pelvic floor exercises
• lifestyle changes, such as reducing coughing, straining during bowel movements and heavy lifting

Moderate prolapse

Treatment may involve:

• lifestyle changes, as above
• visiting a pelvic floor physiotherapist for specific pelvic floor strengthening exercises
• a ring pessary (a small plastic or silicon support) inserted high up into the vagina
• hormone therapy medication such as oestrogen cream to help tone the pelvic floor muscles
• surgery

Severe prolapse

A severely prolapsed bladder usually requires surgery. There are different types of surgery, which your doctor will discuss with you. Recovery usually takes around 6 weeks and you should avoid over-exercising, straining, heavy lifting and sexual intercourse during this time.

Preventing prolapsed bladder

Sometimes there’s nothing you can do to prevent a prolapse if it has been caused by complications in childbirth or it is genetic. However, there are some things you can do which may help:

• Do pelvic floor exercises every day.
• Avoid regularly lifting heavy objects, including children.
• Keep within a healthy weight range to prevent extra stress on your pelvic floor.
• Consume at least 30g of fibre per day and drink 6-8 glasses of water per day to help prevent constipation and straining.
• Do moderate exercise each day to ensure your bowel movements (pooing) remain regular. Exercise that strengthens your core, and avoiding jumping and bouncing, is recommended.

When to seek help

If you are concerned you may have a prolapsed bladder and are experiencing troublesome symptoms, see your doctor. You can also visit a physiotherapist who is trained to help you with pelvic floor exercises. If you are experiencing urinary incontinence associated with a prolapse, a continence nurse adviser may help.

More information

To find out more:

• Download the Prolapse - Don't Ignore the Signs factsheet from the Continence Foundation of Australia.
• Contact the National Continence Helpline on 1800 33 00 66.
• Download the Genital prolapse fact sheet from Women’s Health Queensland.