Decreased Bladder - Symptoms, causes and treatment

Cystocele or bladder descending is the descent of the bladder into the vaginal area which is characterized by a bulge in the vagina. Cystocele causes the sufferer to feel uncomfortable and difficult to urinate.

The bladder is an organ that collects and stores urine. To keep the bladder in place, the bladder is supported by muscles and tissues on the inside of the pelvis. Under certain conditions, the muscles that support the bladder can weaken and cause the organ to descend into the vagina.

Cystocele or bladder drop can be experienced by all women, especially during pregnancy. Pregnancy will cause the pelvic floor muscles to weaken and trigger the descent of the bladder into the vagina. In addition to pregnant women, cystocele is also experienced by many women who have gone through menopause.

Symptoms of Decreased Bladder

At first, people with cystocele may not feel any symptoms. Patients only feel symptoms when the cystocele has gotten worse. Symptoms of a cystocele can include:

  • A visible and can be felt bulge in the vagina.
  • The bladder does not feel empty after urinating.
  • Pain in the vagina, pelvis, lower abdomen, groin, or lower back.
  • Pain during sexual intercourse.
  • Difficulty urinating.
  • Wetting the bed when sneezing, coughing, or lifting heavy objects.

When to go to the doctor

You need to see a doctor if you have a disease that is at risk of causing your bladder to drop, such as a persistent cough or constipation. The doctor will conduct an examination to find the cause, so that he can provide the appropriate treatment.

Immediately consult a doctor if symptoms of cystocele appear as mentioned above. Cystocele should receive treatment immediately to prevent complications, such as prolapse of other organs around the bladder and urinary tract infections.

Causes of Decreased Bladder

As mentioned earlier, a cystocele or bladder drop occurs when the pelvic floor muscles weaken, so they are no longer able to support the bladder. Weakening of the pelvic floor muscles can be caused by several things, namely:

  • Are pregnant or after normal delivery.
  • After undergoing surgery to remove the uterus (hysterectomy).
  • Have excess weight.
  • Often lifts heavy objects.
  • Suffer from chronic cough.
  • Entering menopause.
  • Often experience constipation so that you often strain during bowel movements.
  • Age increase.
  • Descendants.

Descent Bladder Diagnosis

A cystocele or descending bladder is marked by a bulge at the mouth of the vagina, so doctors usually can make a diagnosis just by asking for symptoms and doing a physical examination, especially in the pelvic area. To confirm this, as well as to look for the cause of a drooping bladder, the doctor will perform additional tests in the form of:

  • Urine test and uroflowmetry

    This examination is done to see abnormalities in the urinary tract, as well as see the function of the bladder when holding and urinating.

  • X-ray (sistourethrography)

    This test is done to check the shape of the bladder.

  • Cystoscopy

    Cystoscopy examination aims to see the condition of the inside of the bladder.

  • CT scan or MRI

    This imaging is done to see and examine the condition of the internal organs of the abdomen and pelvis.

Through the examination, the doctor can also measure the severity of the cystocele experienced by the patient. There are four levels of cystocele severity, namely:

  • Mild: Only a small portion of the bladder descends into the vagina.
  • Moderate: The bladder has descended to the vaginal opening.
  • Severe: Part of the bladder has protruded from its normal position until it comes out of the vaginal opening.
  • Very severe: The entire bladder descends to the outside of the vagina.

Urinary Bladder Treatment

The doctor will determine the type of treatment based on the severity of the cystocele. If the cystocele is mild, causes no symptoms, and does not interfere with urine flow, the patient does not need special treatment.

The doctor will only advise the patient to overcome the cause, for example by no longer lifting heavy objects or straining. In addition, the doctor will also recommend patients with mild cystocele to do Kegel exercises to strengthen the pelvic muscles.

If the symptoms that are felt are increasingly disturbing and the above methods are not effective in treating the cystocele, then the urologist or obstetrician will provide treatment in the form of:

  • pessary ring installation

    Estrogen therapy

  • This therapy is done to increase levels of the hormone estrogen in the body, so the muscles around the vagina and bladder will be stronger. Estrogen therapy is aimed at women who have entered menopause.
  • Operation

    Surgery is performed on patients with severe cystocele. The goals of surgery are to raise the descending bladder back to its normal position, remove excess tissue, and strengthen the pelvic muscles.

Patients who underwent cystocele surgery were allowed to go home 1-2 days after surgery. However, the recovery period will take 4-6 weeks.

Bladder Complications Down

If left untreated, a cystocele or drooping bladder can cause urinary incontinence, bladder stones, and descent of organs other than the bladder into the vagina.

Complications can also occur due to surgery, such as bleeding, severe pain in the pelvis or genitals, and bladder injury.

Bladder Drop Prevention

There are several ways that can be done to prevent or reduce the risk of a descending bladder or cystocele, including:

  • Maintain an ideal body weight by exercising regularly.
  • Prevent constipation through consumption of high fiber foods.
  • Do Kegel exercises regularly.
  • Avoid lifting heavy objects.
  • Treat coughs if you have a chronic cough.
  • Quit smoking.