Prolapse of the bladder occurs because the ligaments or pelvic floor muscles have lost their strength, weakening the front wall of the vagina.

The most common symptoms of a bladder prolapse are: a vaginal bulbous feeling, urinary incontinence, difficulty passing urine and pain during intercourse.

There are a number of risk factors that increase the risk of bladder prolapse: previous vaginal deliveries, smoking, obesity and the family history of prolapse.

One or more of the following tests may be performed to diagnose bladder prolapse:

• Urodynamic examination (UDO): measuring bladder pressure

• Cystoscopy: viewing examination in which the doctor looks into the bladder through the urinary tract under local anesthetic

• RX colpo-cysto-defaceography: determination of the function of the pelvic floor with X-rays.

 

A number of treatments are possible, depending on the severity of the prolapse:

• Physiotherapy: strengthen pelvic floor muscles (helps less with large prolapse)

• Pessary: silicone ring that is inserted vaginally and ensures that the prolapsed bladder is repositioned in the correct place

• Front wall plastic - bladder stitching: during this operation, the front wall of the vagina is incised to reinforce and reattach the weakened support tissue under the bladder. If necessary, the excess tissue is removed from the vagina. Afterwards, the vaginal wall is closed again. A net (mesh) is used to reinforce the support fabric.

• Colpopromontoriopexy: during this operation, the bladder prolapse is reduced and the anterior wall and back wall of the vagina are reinforced with a prosthesis (net) that is fixed at the height of the promontory (part of the spine). This procedure is usually performed robot-assisted.