Many senior women may develop a cystocele, which is also known as a fallen bladder, prolapsed bladder, or vaginal prolapse. This condition can lead to very different urinary conditions, including stress incontinence (involuntary loss of bladder control) and urinary retention (inability to urinate or completely empty the bladder). After menopause a cystocele may become worse, but treatments are available that may correct resulting urinary problems.
What is a Cystocele?
A woman’s bladder is normally held in place by pelvic floor muscles. When the muscles become weak, the bladder can drop down into the vagina. The cystocele may be mild with few or no symptoms, but the condition may be more severe with more serious symptoms.
A cystocele may be caused by stress to the pelvic floor muscles. This most commonly occurs after vaginal delivery of a baby with multiple deliveries increasing the risk. Menopause results in lowered estrogen levels, which tends to weaken the pelvic floor muscles further.
Additional factors that may increase the risk for developing a cystocele include:
- lifting heavy objects, including caregivers who lift patients or family members
- lung conditions, particularly those that cause a chronic cough
- constipation, particularly if accompanied by frequent straining
- obesity
- previous surgery in the pelvic area
A healthcare provider may diagnose a cystocele by examination because a grade 2 or grade 3 cystocele is visible. The fallen part of the bladder may be seen at rest and/or with pressure in the area such as with a cough. Other tests may be necessary to diagnose a very mild cystocele.
What are the Symptoms of a Cystocele?
A mild cystocele may not produce any symptoms; however, a cystocele may cause a variety of symptoms, including:
- urinating frequently (polyuria)
- urge to urinate (urgency)
- stress incontinence – leakage of urine when pressure in the abdomen is increased, such as when laughing, coughing, or lifting
- feeling no or little relief after urinating
- frequent UTIs (urinary tract infections)
- urinary retention (complete or partial inability to empty the bladder), which can lead to kidney damage or infection of the kidneys
- feeling pressure or a sense of heaviness in the vaginal area
- pain in the vagina, pelvis, or groin, which may also extend to the lower back or lower abdomen
- painful intercourse
How is a Cystocele Treated?
A mild cystocele with little or no symptoms may not need any treatment. Avoiding strenuous lifting or activities that tend to worsen the cystocele may help to avoid further treatment.
Strengthening the pelvic floor muscles may help a mild cystocele. These exercises are known by several different names such as:
- Kegel exercises
- root lock
- muhla banda
A cystocele that is more advanced or has more serious symptoms may require more aggressive treatment, such as:
- estrogen therapy – this may increase the strength of the pelvic floor muscles
- pessary – a device that is inserted into the area to manually move the bladder in place and may be particularly helpful for those who are not candidates for surgery. Readers may wish to see pictures of various pessaries.
- surgery
Urinary Problems in Senior Women May be due to Cystocele
Many women live with urinary problems, such as stress incontinence and urinary retention, that are due to a cystocele. A prolapsed bladder may result from added pressure to the pelvic floor area, such as with childbirth. Postmenopausal women may experience a worsening of symptoms due to weaker pelvic floor muscles after estrogen levels drop. Fortunately, several treatments may help decrease symptoms of a cystocele, including Kegel exercises, estrogen, a pessary, or surgery.
Readers may also enjoy reading about what causes various colors of urine.
This article is for informational purposes only and should not be considered medical advice.
Sources:
American Academy of Family Physicians May, 2000 online article “Practical Use of the Pessary” by Anthony J. Viera and Margaret Parkins-Pettigrew
Cleveland Clinic 8/31/2007 online article “Cystocele (Fallen Bladder)”
Medline Plus May 7, 2010 online article “Stress Incontinence” by Louis S. Liou and reviewed by David Zieve
Urology Health May, 2009 online article “Bladder Prolapse (Cystocele)”
Katrena Wells - Katrena Wells is a RN in NC with 17 1/2 years of experience in oncology, an educator since 1995, and has taught exercise classes since ...
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