About cystocele - bladder prolapse - and other bladder problems
There are many different kinds of bladder problems that contribute to incontinence. One problem is a prolapsed bladder - cystocele - where the bladder pushes into the vagina. Because of the way it impacts the angle of the bladder and the urethra, bladder leakage often occurs.
Correction of cystocele
There are a number of non-surgical treatments for a fallen bladder that relieve symptoms. Visit this page of our website for more information on a full range of treatments for female urinary incontinence. However, sometimes surgery is needed to correct a prolapsed (dropped) bladder and restore function.
There are different kinds of surgical procedures that are used. At Minnesota Women's Care, we believe the procedure that's used must be based on you – your concerns, desires, anatomic defects, and symptoms. Dr. Ashford is able to correct prolapse with or without the use of mesh.
Female Pelvic Organs
Types of bladder control issues and bladder prolapse symptoms
Stress incontinence - Leaking small amounts of urine during physical movement (coughing, sneezing, exercising). Stress incontinence is the most common form of incontinence in women. It is treatable.
Urge incontinence - Leaking large amounts of urine at unexpected times, including during sleep, after drinking a small amount of water, or when you touch water or hear it running (as when washing dishes).
Functional incontinence - Not being able to reach a toilet in time because of physical disability, obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet. For example, a person with Alzheimer's disease may not think well enough to plan a trip to the bathroom in time to urinate or a person in a wheelchair may be blocked from getting to a toilet in time.
Overflow incontinence - Leaking small amounts of urine because the bladder is always full. With this condition, the bladder never empties completely. Overflow incontinence is rare in women.
Mixed incontinence - A combination of incontinence, most often when stress and urge incontinence occur together.
Transient incontinence - Leaking urine on a temporary basis due to a medical condition or infection that will go away once the condition or infection is treated. It can be triggered by medications, urinary tract infections, mental impairment, restricted mobility, and stool impaction (severe constipation).
What causes bladder problems?
During pregnancy, the added weight and pressure of the unborn baby can weaken pelvic floor muscles, which affects your ability to control your bladder. Sometimes the position of your bladder and urethra can change because of the position of the baby, which can cause problems.
Vaginal delivery and an episiotomy (the cut in the muscle that makes it easier for the baby to come out) can weaken bladder control muscles. And, pregnancy and childbirth can cause damage to bladder control nerves. After delivery, the problem of urinary incontinence often goes away by itself. But if you are still having problems 6 weeks after delivery, talk to your health care provider. Bladder control problems don't always show up right after childbirth. Some women do not have problems with incontinence until they reach their 40's.
Menopause (when your periods stop completely) can cause bladder control problems for some women. During menopause, the amount of the female hormone estrogen in your body starts decreasing. The lack of estrogen causes the bladder control muscles to weaken. Estrogen controls how your body matures, your monthly periods, and body changes during pregnancy and breastfeeding. Estrogen also helps keep the lining of the bladder and urethra plump and healthy.
Questions about bladder surgery and prolapse repair
Certain cystoceles may require surgery to repair. During this surgery, the bladder is moved back into a more normal position and procedures are then used to keep it in position. Many women who are considering surgery have these questions:
How will you correct my prolapse?
Your procedure will be based upon your concerns, desires, anatomic defects, and symptoms.
Do you use mesh?
Sometimes. Dr. Ashford is able to correct prolapse with or without the use of mesh. Many women are good candidates for surgical mesh. Dr. Ashford has been using mesh in pelvic reconstructive procedures to repair pelvic organ prolapse (prolapse of bladder, rectum, uterus and vaginal cuff) since 2001 and has achieved very favorable results. He will discuss the pros and cons of mesh for your repair so you can make the best decision for you.
What results have other patients had mesh?
Dr. Ashford has been using implanted transvaginal mesh in various forms for more than 10 years. The most common risks of mesh placement include exposure of mesh material called erosion (about 3% of the time to date), and/or pain with intercourse (in about 2 - 3% of patients). Although complications can occur with any surgery, the overwhelming majority of Dr. Ashford's patients have reported that they are very satisfied with the results.
About Dr. Ashford:
OBGYN & Urogynecologist
Dr. Ashford is board-certified in both OBGYN and Female Pelvic Medicine & Reconstructive Surgery (FPMRS) - a field more commonly known as Urogynecology. This unique training and experience qualifies him to repair even the most advanced cases of cystocele and other pelvic organ prolapses.