Prolapsed Bladder and Prolapsed Uterus

Difference Between Prolapsed Bladder and Prolapsed Uterus

Overview of Prolapsed Bladder and Prolapsed Uterus

Prolapsed Bladder and Prolapsed Uterus involve the descent of pelvic organs from their normal positions, potentially causing discomfort and urinary symptoms.

Prolapsed bladder (cystocele) occurs when the urinary bladder shifts into the vaginal area due to compromised pelvic support, leading to symptoms like urinary leakage and pelvic pressure. Prolapsed uterus (uterine prolapse), on the other hand, refers to the uterus prolapsing into or beyond the vaginal canal due to childbirth or menopause factors and often leading to discomfort as well as possible urinary or bowel issues.

Both conditions are treated either using non-invasive measures like exercises or surgical interventions if severe therefore consultation with healthcare providers is key when seeking a diagnosis and tailored treatment plans tailored specifically for diagnosis and tailored care plans for treatment plans tailored for each case.

What is a Prolapsed Bladder?

Prolapsed bladder (also referred to as cystocele) is a medical condition in which the bladder protrudes out from its regular location in the pelvic cavity and protrudes into vaginal areas, due to the weakening of supportive tissues and muscles that hold it securely in place often caused by pregnancy, childbirth, obesity, chronic coughing or heavy lifting that strains its pelvic floor.

Prolapsed bladder symptoms vary but typically include pelvic pressure or fullness, discomfort during intercourse, urinary leakage (stress incontinence), and difficulties emptying the bladder completely. Sometimes a visible bulge or tissue protrusion at the vaginal opening may also be evident.

Prolapsed Bladder
Figure 01: Prolapsed Bladder

Diagnosis typically involves undergoing a medical examination where a healthcare provider can evaluate the degree and impact of bladder descent on a person’s quality of life. Treatments range from conservative approaches, like pelvic floor exercises to strengthen muscles, pessaries (supportive devices), or making lifestyle modifications to reduce symptoms to more drastic approaches such as surgery to restore proper positioning of the bladder.

Early intervention is critical in order to manage symptoms and potential complications. People experiencing urinary changes, discomfort or pressure in their pelvic region should seek medical advice immediately an experienced healthcare provider will be able to accurately diagnose, recommend suitable treatments, and offer guidance as to how best to manage and prevent further progression of their condition.

Causes of Prolapsed Bladder

  • Pregnancy and Childbirth: Pregnancy and vaginal childbirth can stretch and damage pelvic floor muscles and ligaments, especially when prolonged pushing is involved or forceps or vacuum extraction are used during birthing.
  • Aging: With age comes the loss of strength and elasticity in pelvic muscles and tissues, increasing the risk of pelvic organ prolapse including cystocele.
  • Estrogen Levels: Postmenopausal estrogen decline can have adverse consequences on pelvic tissues and muscles, rendering them more vulnerable to weakness and prolapse.
  • Chronic Constipation and Straining: Regular straining during bowel movements due to chronic constipation can put undue strain on the pelvic floor, weakening supportive structures over time and further contributing to irregularity of bowel movements.
  • Chronic Coughing: Chronic Obstructive Pulmonary Disease (COPD), which often leads to persistent coughing, can strain pelvic floor muscles over time.
  • Obesity: Carrying excess body weight places an additional strain on the pelvic floor and can contribute to its weakening.
  • Repetitive Heavy Lifting: Regularly lifting heavy objects or engaging in activities in which straining can increase the risk of pelvic floor muscle weakening.
  • Genetic Factors: Certain people may inherit a predisposition that makes them more prone to pelvic organ prolapse, including cystocele.
  • Connective Tissue Disorders: Certain connective tissue disorders can threaten to weaken and compromise the supporting structures for pelvic organs, potentially impacting their strength and integrity.

Symptoms of Prolapsed Bladder

Symptoms of Prolapsed Bladder (Cystocele):

  • Pelvic Pressure: Feeling of heaviness or fullness in the pelvic area.
  • Discomfort: Uncomfortable sensation in the lower abdomen or pelvis.
  • Urinary Leakage: Involuntary urine leakage, especially during activities like laughing, sneezing, or lifting.
  • Incomplete Emptying: Sensation that the bladder is not completely empty after urination.
  • Painful Intercourse: Discomfort or pain during sexual intercourse.
  • Visible Bulge: Sometimes, a noticeable bulge at the vaginal opening.
  • Frequent Urination: Increased need to urinate due to bladder irritation.
  • Urinary Tract Infections: Recurrent infections due to incomplete bladder emptying.

What is a Prolapsed Uterus?

Prolapsed Uterus or Uterine Prolapse occurs when the uterus protrudes out from its normal position within the pelvis and protrudes beyond or even into the vaginal canal, typically as a result of weak pelvic floor muscles and supportive ligaments that normally keep it in its place, factors contributing to their weakening include childbirth, multiple pregnancies, age, hormonal changes or conditions that increase intra-abdominal pressure like chronic coughing or heavy lifting.

 Prolapsed Uterus
Figure 01: Prolapsed Uterus

Prolapsed uteri may produce various symptoms that range from pelvic pressure or fullness, discomfort during sexual intercourse, and backache to difficulty with urination, bowel movements or visible bulging at the vaginal opening. Their severity varies widely with some cases being relatively mild while others are more pronounced.

Diagnosis typically involves undergoing a thorough medical exam so a healthcare professional can ascertain the degree of uterine descent and its impact on an individual’s well-being. Treatment options depend on its severity options could include pelvic floor exercises, lifestyle modifications, and using pessaries (supportive devices). In more serious cases, surgical procedures might also be considered in order to repair supportive tissues and reposition the uterus.

Prompt medical attention is vital in managing uterine prolapse. Women experiencing symptoms like pelvic discomfort, urinary or bowel changes or visible protrusion should immediately seek medical advice from healthcare providers to accurately diagnose their condition, recommend suitable treatments, and guide their way to improved pelvic floor health and halt further decline.

Causes of Prolapsed Uterus

  • Childbirth: Vaginal delivery, particularly multiple pregnancies or difficult births, can strain and weaken pelvic floor muscles and ligaments, leading to uterine descent.
  • Weakening of Supportive Tissues: As people age, hormonal shifts (such as decreased estrogen after menopause), and repeated strain on pelvic tissues can all play a part in weakening the structures that support the uterine area, eventually weakening uterine supports and even leading to miscarriage.
  • Pregnancy: With increased uterine weight during gestation comes an increased strain on pelvic floor muscles which could potentially cause prolapse.
  • Chronic Strain: Constipation, persistent coughing (e.g. from chronic lung diseases), or heavy lifting can all place strain on pelvic floor muscles and contribute to their strain.
  • Genetic Factors: Some individuals could inherit weaker pelvic floor structures that make them more prone to prolapse of the uterus.
  • Obesity: Carrying extra body weight can increase pelvic floor pressure and contribute to prolapse.
  • Connective Tissue Disorders: Instances involving connective tissues can wreak havoc with uterine structures and weaken them over time, making uterus care even more challenging than it would otherwise be.
  • Hysterectomy: Surgery to remove the uterus can compromise its supporting ligaments and increase the risk of prolapse if other pelvic structures are weakened as a result of its removal.
  • Muscle Atrophy: Lack of exercise or inactivity can result in muscle atrophy, including those found within the pelvic floor.

Symptoms of Prolapsed Uterus

Symptoms of Prolapsed Uterus (Uterine Prolapse):

  • Pelvic Pressure: Feeling of weight or pressure in the pelvic area.
  • Vaginal Discomfort: Unease or fullness within the vaginal region. Backache: Lower back discomfort that often gets worse while standing.
  • Difficulty Urinating: Straining or weak urine stream due to pressure from the uterus on the bladder. Bowel Issues: Constipation or difficulty with bowel movements caused by pushing against the rectum by the uterus. mes Painful Intercourses: Discomfort during sexual interplay that makes intimacy uncomfortable or painful.
  • Vaginal Bleeding: Spotting or bleeding after physical activity or sexual contact. Visible Tissue: Protrusion or bulge of tissue from the vaginal opening. Incontinence: Urinary leakage during activities which increases abdominal pressure.

Comparison Chart between a Prolapsed Bladder and a Prolapsed Uterus :

Here’s a concise comparison chart highlighting the key differences between a prolapsed bladder (cystocele) and a prolapsed uterus (uterine prolapse):

Aspect Prolapsed Bladder (Cystocele) Prolapsed Uterus (Uterine Prolapse)
Organ Affected Bladder Uterus
Location of Displacement Into vaginal area Into or beyond the vaginal canal
Primary Symptoms Urinary leakage, pelvic pressure, discomfort Pelvic pressure, vaginal discomfort, backache
Impact on Intercourse Discomfort during intercourse Pain or discomfort during sexual activity
Bowel Disruption Uncommon May cause constipation or difficulty defecating
Visible Bulge Generally not visible Bulge or protrusion at vaginal opening
Relationship to Childbirth Often linked to childbirth Can result from multiple pregnancies
Hormonal Influence Minimal Hormonal changes after menopause may contribute
Surgical Intervention Generally less common May require surgical repair if severe

Diagnosis and Treatment

Diagnosis of Prolapsed Bladder

  • Medical History: When speaking with healthcare providers about pelvic organ prolapse symptoms and their duration, as well as relevant medical histories like pregnancies, childbirth, surgeries, or any conditions that might contribute, an initial interview typically includes inquiring into your symptoms, their duration, and any potential contributors such as pregnancies, childbirth or surgeries that might exacerbate pelvic organ prolapse.
  • Physical Examination: Your healthcare provider will perform a pelvic exam. This may involve you lying down while they gently inspect your vaginal and pelvic area to assess the extent of prolapse, its degree of descent, and its effect on surrounding tissues.
  • Valsalva Maneuver: Your doctor may ask you to perform the Valsalva Maneuver, in which you consciously bear down or strain as though having a bowel movement while they observe its extent and response to abdominal pressure.
  • Cystoscopy (Optional): When necessary, cystoscopy may be performed. This involves inserting a thin tube equipped with a camera (a cystoscope) into the urethra and bladder to assess its health, function, and potential complications.
  • Urodynamic Testing (Optional): If urinary symptoms are prominent, urodynamic tests might be conducted to evaluate bladder function, urine flow, and pressure changes during the filling and emptying cycles of the bladder.

Treatment of Prolapsed Bladder

Lifestyle Modifications:

  • Weight Management: Striving to maintain a healthy weight can alleviate pressure on the pelvic floor.
  • Dietary Changes: Eating foods high in fiber may help alleviate constipation and straining during bowel movements.
  • Fluid Intake: Hydration Supports Healthy Bladder Function

Pelvic Floor Exercise and Kegel exercises:

  • Kegel exercises may provide support for bladder function while alleviating symptoms, so strengthening pelvic floor muscles with exercises may provide much-needed assistance and improve quality of life. A healthcare provider will advise on proper technique.


  • Supportive Devices: Pessaries can provide much-needed bladder support and relief from symptoms. There are various varieties available and healthcare professionals can help select an ideal pessary.

Estrogen Therapy:

  • For Postmenopausal Women: Vaginal creams, rings and tablets containing estrogen may help improve vaginal tissue health and elasticity thereby decreasing symptoms.

Surgical Intervention:

  • Anterior Colporrhaphy:  Options available could include Anterior Colporrhaphy reconstructing vaginal walls to support bladder activity.
  • Mesh Repair: Synthetic mesh may be used to reinforce supportive structures.

Sling Procedures:

  • In cases of stress urinary incontinence, a sling may be placed to support both the urethra and bladder.

Diagnosis of Prolapsed Uterus

  • Medical History: Review symptoms, pregnancies, childbirth, surgeries, and any relevant factors in relation to your medical history.
  • Physical Examination: Pelvic examination to asses uterus position, degree of descent, and impact on nearby structures.
  • Pelvic Organ Evaluation: Evaluate uterine position, the extent of descent into the vaginal canal, and any possible effects on adjacent organs.
  • Prolapse Grading: Classify the severity of prolapse to help inform treatment decisions and guide decision-making processes.
  • Valsalva Maneuver: To assess how prolapse responds to abdominal pressure during straining.
  • Imaging (if necessary): Imaging tests such as pelvic ultrasound or MRI may provide detailed visuals, providing greater understanding and allowing you to make decisions with confidence.

Treatment of Prolapsed Uterus

Treatment of Prolapsed Uterus (Uterine Prolapse):

  • Lifestyle Changes: Strive for healthy weight management, include fiber in your diet, and perform Kegel exercises regularly (Pilates Floor Exercise).
  • Pessaries: Utilize vaginally-inserted supportive devices to lift and support the uterus.
  • Estrogen Therapy: Postmenopausal women may find local estrogen therapy beneficial in improving vaginal health and elasticity.
  • Physical Therapy: Pelvic floor exercises led by a physical therapist strengthen pelvic muscles.
  • Surgery: For severe cases, surgical options include uterine suspension or hysterectomy as surgical solutions.
  • Combination Approach: Tailored approaches may involve using multiple therapies tailored specifically to an individual’s needs.

Prevention Tips for Prolapsed Bladder and Prolapsed Uterus

Prevention tips to avoid prolapsed bladder (cystocele) and prolapsed uterus (uterine prolapse) include:

  • Floor Exercise: Pelvic Floor Exercise (Kegels) should be performed regularly to strengthen muscles supporting pelvic organs and maintain good pelvic health.
  • Maintain a Healthy Weight: To reduce pressure on pelvic structures, maintaining a healthy weight is key.
  • Proper Lifting Technique: To avoid straining pelvic muscles and reduce backache, the optimal technique for lifting heavy objects should involve using only your legs and not your back to lift.
  • Adequate Fluid and Fiber Intake: Prevent constipation by staying well hydrated and eating a high-fiber diet.
  • Combat Chronic Cough: Treat chronic cough early to avoid overstretching pelvic tissues.
  • Avoid Heavy Lifting: Avoid engaging in heavy lifting which strains the pelvic region.
  • Correct Postpartum Care: After giving birth, ensure the appropriate postpartum exercises and care are followed for optimal pelvic recovery.
  • Estrogen Therapy (for postmenopausal women): For appropriate hormonal therapy recommendations, contact your healthcare provider for guidance.
  • Avoid Prolonged Straining: Prevent prolonged straining during bowel movements by adhering to a healthy diet and adequate hydration practices.
  • Get Regular Checkups: Involve yourself in regular gynecological check-ups in order to maintain optimal pelvic health.
  • Prompt Treatment: Address symptoms such as pelvic pressure or discomfort quickly in order to stop their further progression.

Pros and Cons of Non-Surgical vs. Surgical Options for Prolapsed Bladder and Prolapsed Uterus

Non-Surgical Solutions for Prolapsed Bladder and Uterus: Here Are Your Options:

Pros of Non-Surgical Options for Recovery

  • Conservative Approach: Non-surgical approaches tend to be less invasive, avoiding surgery’s risks altogether. Lower Risks: Recovery time often is faster allowing individuals to return to daily activities faster.
  • Non-Surgical Solutions Are Appropriate for Mild Cases: Non-invasive approaches tend to work well for milder forms of prolapse. No Anesthesia Is Needed: Most non-surgical techniques do not require anesthetic for use, with pros and cons including limited effectiveness for more severe or advanced forms.
  • Symptom Management: Non-invasive therapies often focus more on managing symptoms than offering permanent solutions, while regular maintenance like pessary use is required in some instances.
  • Non-Surgical Options May Not Suit Everyone: Depending on the severity of prolapse, non-surgical remedies may not be sufficient treatment options for all individuals.

Surgical Options for Prolapsed Bladder and Uterus:

Pros of Surgery for Orthopedic Conditions:

  • High Success Rate: Surgery can provide more definitive results in severe cases than alternative forms of therapy do, including permanent solutions and immediate relief from symptoms.
    Tailor-Made Solutions: Each surgical technique can be customized to the individual’s specific needs. Invasive: Surgery may involve more invasive procedures and carry additional risks associated with anesthesia and surgery.
  • Recovery Time: Recovering after surgery typically takes more time, with restrictions placed on activities to speed up the healing process.
  • Complications: Surgery may lead to unexpected consequences like infection, bleeding, or injury to nearby structures that could arise as complications.
  • Cost: Surgical interventions may be more expensive due to hospitalization fees and postoperative follow-up care costs.

Risk Factors for Prolapsed Bladder and Prolapsed Uterus

There are multiple risk factors that contribute to prolapsed bladder (cystocele) and prolapsed uterus (uterine prolapse) conditions, with pregnancy and childbirth often playing an influential role in cystocele cases Pregnancy-induced pelvic floor muscle weakness increases the likelihood of bladder descent risk in cystocele cases. Other factors, including obesity, chronic coughing and repetitive heavy lifting also put strain on the pelvic floor, potentially contributing to cystocele.

With regard to uterine prolapse, multiple pregnancies can weaken pelvic structures over time allowing it to descend further down into the vaginal canal. Hormonal changes after menopause, particularly the drop in estrogen levels, contribute to tissue weakening. Age, genetics, and conditions such as constipation all increase this risk further.

Women who have undergone hysterectomy or suffer from connective tissue disorders could also be more prone. Maintaining a healthy weight, practicing pelvic floor exercises regularly and promptly treating chronic conditions can all help mitigate risk factors and lessen the likelihood of prolapsed bladder and uterus prolapses.


Prolapsed bladder (cystocele) and prolapsed uterus (uterine prolapse) are conditions in which pelvic organs deviate from their normal positions, causing discomfort and other symptoms. Prolapsed bladder occurs when the bladder shifts into vaginal areas due to weak pelvic floor muscles prolapsed uterus occurs when it descends below the vaginal canal due to weak supporting structures.

Symptoms of both conditions include pelvic pressure, discomfort, urinary changes, and backache/bowel issues in cases of prolapse. Diagnosis involves a medical history review, physical exam and potential imaging studies Prevention strategies include pelvic floor exercises, maintaining a healthy weight, using correct lifting techniques, as well as managing chronic conditions like a cough.

Treatment options range from non-invasive (lifestyle changes, exercises, and pessaries) to surgical interventions (uterine suspension and hysterectomy). Each approach offers its own set of advantages and disadvantages Non-invasive approaches tend to be less invasive while surgical methods offer more definitive results. It is essential to consult a healthcare provider for accurate diagnosis and tailored treatment plans.