by Valerie L. Burkhard, M.D.
A woman’s body undergoes many changes throughout her lifetime. Puberty, childbearing years and menopause are all expected to bring changes. However, something women may not plan for is problems with bladder health.
Local Urologist, Dr. Valerie Burkhard, treats bladder problems often associated with frequent urination, urgency, infections and incontinence. But there are other conditions she treats, such as a cystocele, also known as a prolapsed or fallen bladder, of which to be aware.
Symptoms
A cystocele occurs when the muscle wall between a woman’s bladder and vagina weakens, allowing the bladder to droop and bulge into the vagina. A woman can report feeling pressure while sitting or the feeling that something is “falling” out of her body. Other symptoms may include:
* fullness in the pelvis
* a feeling that the bladder hasn’t completely emptied after urinating
* recurrent bladder infections
* pain during intercourse
* visual appearance of a bulge protruding vaginally
Causes
Normally, strong muscles and ligaments keep the bladder separated and lifted above to the vagina. However, due to multiple pregnancies and vaginal births (a main contributor), the muscles may gradually weaken. Straining repeatedly due to constipation, heavy lifting or obesity can also contribute to prolapse.
Some women are genetically predisposed to having weak connective tissue in their pelvis and may be at higher risk. Others find they have no symptoms until after they’ve experienced menopause when estrogen production decreases. Estrogen is largely responsible for keeping pelvic muscles strong.
Treatment
A thorough examination is essential to diagnose a prolapsed bladder. Often a urologist will perform tests to visualize the bladder, known as a cystoscopy, and to measure how the bladder functions, fills and empties, known as urodynamics.
For mild cases, muscle-tightening Kegel exercises may resolve symptoms and help lift the bladder back into its correct position. Physical therapy programs like pelvic floor rehabilitation are often successful in treating mild symptoms.
In more severe cases, the use of a pessary could be prescribed by a gynecologist. This is a device that holds the bladder into position. The downside is that it has to be removed, cleaned and reinserted periodically and may also cause irritation, bleeding, and pain.
Surgery is the definitive cure to replace the bladder into its correct position. Often times, mesh is used as a “hammock” to replace the weak muscles to prevent recurrence of the prolapse, which can be as high as 60% without use of mesh.
Urinary incontinence, or leakage, often coincides with prolapse. More importantly, if not addressed by a urologist and repaired at the time of surgery, this could worsen after prolapse correction.
My patients find comfort and expertise in a female urologist and it is a privilege to provide them with successful treatment options that many of them have long been seeking.
About the Author:
Valerie L. Burkhard, M.D. is the only full time board certified female Urologist in Western New York. She is affiliated with all major hospitals in Western New York and sees patients in three offices including Williamsville, Buffalo and Orchard Park. To learn more visit Buffalo Medical Group atwww.buffalomedicalgroup.com. She can be reached at 716-630-1050.
