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Urology
Bladder Prolapse
Pelvic organ prolapse (bladder prolapse) is a significant health condition that directly affects women's health and quality of life, developing primarily due to advancing age and childbirth factors.
ℹWhat is Bladder Prolapse?
Under normal conditions, the organs in the pelvic region are supported by a "hammock" structure consisting of strong muscles and connective tissues. Cystocele is the prolapse of the bladder into the vagina as a result of the weakening of the supporting tissue between the urinary bladder and the anterior vaginal wall.
Staging
- Stage 1 (Mild): Bladder has descended to the upper vagina.
- Stage 2 (Moderate): Bladder has reached the vaginal opening.
- Stage 3 (Severe): Bladder protrudes beyond the vaginal opening.
- Stage 4 (Complete Prolapse): Bladder is entirely outside the vagina, often accompanied by uterine and rectal prolapse.
Common Symptoms
Vaginal Swelling
A palpable soft mass or a feeling of fullness at the vaginal entrance.
Sensation of Pressure
A feeling of pulling downward or pressure in the pelvic region.
Urinary Problems
Difficulty urinating, sensation of incomplete emptying, or urinary frequency.
Stress Incontinence
Urinary leakage with laughing, coughing, or heavy lifting.
Sexual Dysfunction
Dyspareunia (pain during intercourse) or discomfort.
Back Pain
Lower back pain that increases especially in the later hours of the day.
Diagnosis Methods
Pelvic Examination
The degree of prolapse, pelvic floor muscle strength, and accompanying conditions are evaluated using the Valsalva maneuver.
Post-Void Residual (PVR) Urine
Ultrasound measurement of urine remaining in the bladder after voiding.
Urodynamics
Functional tests that measure the bladder's capacity to hold and empty urine.
Cystoscopy
Observation of the inside of the bladder with a camera in cases deemed necessary.
Treatments
Pelvic Floor Exercises (Kegel)
Can stop progression by strengthening muscles in mild stages.
Pessary Use
Silicone rings placed inside the vagina to support organs in their anatomical position.
Vaginal Repair (Anterior Colporrhaphy)
Tightening of weakened tissues through a vaginal incision.
Robotic/Laparoscopic Sacrocolpopexy
Suspension of the bladder and vaginal vault to sacral bone using polypropylene mesh for severe prolapse. The gold standard surgery.