Obesity is a serious disease that affects several bodily functions and is linked to certain types of cancer. Unfortunately, it’s exceedingly common for adults in the U.S. According to the CDC, adult obesity prevalence increased from 30.5% in 1999 to 42.4% in 2018.
Behavior, environment, and genetics can all play a part in the cause of obesity — it’s a complex disease that typically is the result of several contributing factors. However, regardless of the cause, obesity can significantly reduce a person’s quality of life and lead to severe consequences.
On top of the other health conditions linked to obesity, there is increasing evidence that shows a link between obesity and bladder prolapse.
What Is a Cystocele?
Normally, the bladder, the hollow organ that stores urine, is suspended in the pelvis by support tissue, including the front wall of the vagina.
When everything is working by design, the bladder fills with urine and creates pressure which leads to the urge to urinate. The pelvic floor muscles relax, resulting in urine traveling out of the bladder and exiting through the urethra.
However, the front wall of the vagina is susceptible to weakening, especially as women age, give birth, or if the body undergoes significant stress.
If the pelvic floor muscles and vaginal wall sustain enough deterioration, the bladder can prolapse, meaning it no longer receives the support it needs from the vaginal wall. A prolapsed bladder, also known as a cystocele or fallen bladder, may drop and push into the vagina, leading to an array of urinary difficulties, discomfort, and pain.
Bladder prolapse is a type of pelvic organ prolapse, and while it is typically not life-threatening, any woman suffering from this condition should see their doctor.
Can Obesity Cause Bladder Prolapse?
Obesity already poses a significant health risk factor to a great number of other issues. Diabetes, heart disease, arthritis — the list goes on. However, many women may not realize that obesity is also linked to a number of gynecological conditions, including infertility, uterine fibroids, and bladder prolapse.
According to a study from the American Journal of Obstetrics and Gynecology, overweight and obese women are significantly more likely to experience pelvic organ prolapse, such as bladder prolapse, than women of normal weight.
A study from Vanderbilt University in Nashville found that the risk factor for prolapse for overweight women compared to normal-weight women ranged from 1.36 to 1.40. For obese women, the risk ratio range increased to 1.47 to 1.61.
Women must understand the risk associated with obesity and bladder prolapse. Furthermore, because pelvic organ prolapse is not widely discussed or understood, women don’t always know what it is, what the contributing factors are, and what treatments are available.
What Causes Bladder Prolapse?
On top of being overweight or obese, there are several risk factors linked to bladder prolapse. These include having a hysterectomy, advanced age, family history, and connective tissue disease.
Other common causes of bladder prolapse include:
- Pregnancy Childbirth: The delivery process and childbirth cause a great deal of stress to the vaginal tissues and pelvic floor muscles, all of which are necessary to support the bladder. Childbirth is one of the most common causes of a prolapsed bladder.
- Menopause: The vagina uses estrogen to help maintain the strength and health of the vaginal muscles. After menopause, estrogen levels drop, leading to a weakened vaginal wall resulting in a prolapsed bladder.
- Weak pelvic floor muscles: Straining during a bowel movement, excessive coughing, long-term constipation, or straining while picking up a heavy object can damage the pelvic floor muscles, increasing the risk of a prolapsed bladder.
While many of these risk factors and causes are nonmodifiable, obesity is a modifiable risk factor that women can take steps to address, which can help prevent bladder prolapse.
Other steps women can take to prevent a prolapsed bladder include eating a high-fiber diet and drinking plenty of fluids to reduce the risk of constipation and excessive straining. If possible, avoiding heavy lifting can also be used as a prevention measure.
Symptoms of a Prolapsed Bladder
Prolapsed bladders and the accompanying symptoms vary in severity and depend on other factors such as the presence of other types of prolapse, the women’s level of physical activity, and other health conditions.
Symptoms of a prolapsed bladder can include:
- Pain or discomfort during intercourse
- Leaking urine during intercourse
- Feeling the urge to empty your bladder more frequently than usual
- Pressure in the pelvic area even if the bladder is empty
- Urinary stress incontinence
- Inability to empty the bladder
- Recurring UTIs
- Feeling pressure inside the vagina
- A bulge or swelling at the vagina’s opening
- Low back pain
- Intra-abdominal pressure
There may be a protrusion of the vaginal wall out through the vaginal entrance in severe cases.
If you are experiencing any symptoms of a prolapsed bladder, it’s critical that you see your doctor. The longer a prolapsed bladder goes untreated, the more severe the symptoms can become.
Diagnosis
To diagnose a prolapsed bladder, your doctor will review your medical history, check for possible risk factors, and perform a vaginal examination. An internal examination is necessary to assess the degree of the prolapse, check for pelvic floor muscle dysfunction, and see if there are any other abnormalities in the pelvic region.
Another test may be necessary to confirm the diagnosis, such as a pelvic ultrasound, a bladder scan, or the use of urodynamics to test bladder function and check for incontinence.
Your diagnosis will likely receive a grade that assesses the severity of the prolapse.
A standard grading scale for bladder prolapses uses stages:
- Stage 1: The bladder protrudes slightly into the vagina mild
- Stage 2: The bladder protrudes so far into the vagina that it is close to the opening of the vagina moderate
- Stage 3: The bladder protrudes out of the vaginal opening advanced
The stage of the prolapse can influence how your doctor recommends you manage and treat it.
Treatment Options for a Prolapsed Bladder
There are several options for treating a prolapsed bladder. Stage 1 prolapses, which are the mildest, may only require rest and the avoidance of straining or lifting heavy objects.
Other treatment options may include:
- Weight loss
- Kegel exercises
- Placing a pessary into the vagina to hold the bladder in place
- Hormone replacement therapy to strengthen the muscles around the bladder and vagina
More severe cases that cannot be managed with a pessary may require surgery to relocate the bladder into its normal position.
Seek Bladder Prolapse Treatment Today
Have you recently been diagnosed with a prolapsed bladder or are experiencing some of the telltale symptoms? If so, Advanced Gynecology is here to help.
Our board-certified team of specialists is here to provide the care and support you need for all of your health needs — including treatment for a prolapsed bladder. We’ll work with you to tailor a treatment plan that fits your health needs and will be with you every step of the way.
For more information, schedule an appointment today or call 678-201-1283 to speak with a patient coordinator.