Bladder prolapse in women - a few drops of urine when coughing should alert you

Folk remedies

Mild symptoms of bladder pathology in women are most often perceived as inevitable age-related changes that cannot be influenced. When the disease develops in the final stages, only surgical intervention is possible to restore health. Prolapse of the bladder in women occurs in almost everyone. Rarely in men. Their main problem is prostatitis and adenoma. You need to know the symptoms and start treatment with herbs and special exercises in a timely manner.

Taking care of your health

The vast majority of the fairer sex believes that the occurrence of problems with women's health with the onset of a certain age is the norm.
This approach is fundamentally wrong, since any possible pathologies, including prolapse of the bladder, can be effectively treated if you promptly contact the appropriate specialist. You should always remember the main symptoms of bladder prolapse. If you are concerned about at least one of them, do not attribute it to age and do not try to find non-existent diseases, make an appointment with a specialist. The doctor will thoroughly understand your situation and help you recover.

You are now familiar with the symptoms of bladder prolapse in women.

Characteristics of the disease

As cystocele develops, bladder prolapse increases, and this happens for various reasons. The muscles and ligaments that supported the organ in the desired position weaken. A rapid decrease in muscle tone ends with a change in the anatomical position of the organ.

The patient experiences prolapse of an internal organ, and this condition causes severe discomfort. Patients often turn to a specialist with complaints that they have difficulty urinating. In addition, urges become more frequent, and most of them are false.

With further progression of the pathology and lack of treatment, manifestations such as urinary incontinence, pain and discomfort may appear. They occur especially often during various physical activities on the walls of the bladder, for example, when coughing or sneezing.

A characteristic sign of the disease is disturbances in the position of the sphincter, and it loses the ability to hold urine. With severe prolapse, the organ moves to the vaginal area and becomes clearly visible. Patients develop problems with urinary retention, and the pathological process itself causes pain in the sacrum and a feeling of heaviness in the perineal area.

Correction with a synthetic implant OPUR (OPUR)

Normally, the bladder, uterus, vagina, and rectum are held in place by ligaments and muscles. However, the natural position of the pelvic organs can be disrupted by traumatic childbirth, chronic diseases, as a result of genetic preconditions, decreased levels of female sex hormones, etc.

Prolapse (prolapse) of the uterus, vaginal walls and bladder in women is usually called prolapse of the pelvic organs or pelvic prolapse. The disease affects half of women over 50 years of age.

The operation is indicated for all types of prolapse, especially with severe uterine prolapse. The bladder, like in a hammock, is held in place by a polypropylene mesh. Six arms and 8 fixation points provide natural and reliable support for the pelvic organs throughout life.

The implant is installed transvaginally, without stitches. After three days, the patient returns to her usual lifestyle without any restrictions. The effectiveness of the operation is 97 percent, there is no risk of relapse.

Together with OPUR, the surgeon can correct the posterior wall of the vagina (posterior colpoperioneraphy), restore the correct physiological position of the main muscle of the perineum - the levator ani muscle (levatoroplasty).

OPUR has no significant disadvantages.

Causes

Features of the development of cystocele are excessive loads on the bladder, weakening of the tone of the ligaments and muscles that support it. This happens for a number of reasons, for example:

• Excess body weight and sudden weight loss.
• If a woman has had several pregnancies and natural births with a short interval between them, the uterus shifts downward. This also includes the use of forceps during obstetrics, numerous internal ruptures (for example, with a narrow pelvis in a woman).
• Excessive physical activity, difficult working conditions at an early age or during menopause, during pregnancy.
• Frequent constipation.
• Weakness of the pelvic floor muscles, asthenia associated with relaxation of the abdominal muscles.
• Tumor in the pelvic organs.
• Hormonal imbalance associated with a decrease in estrogen levels in the female body or during menopause.
• Genetic characteristics, such as those associated with hereditary diseases.

Degrees of cystocele

Experts distinguish three degrees of cystocele disease. Depending on the severity of this disease, appropriate treatment for bladder prolapse in women is prescribed.

The first degree is considered the easiest. It is diagnosed with the slightest displacement. In this case, as a rule, no obvious discomfort is observed, most or all symptoms are absent. It is worth noting that you will never be able to identify a cystocele at this stage on your own; this is only possible as a result of a thorough gynecological examination during the process of straining.

The second stage is a moderate degree. It can also be determined only during a gynecological examination, but without straining the muscles of the abdominal wall. At this stage, the disease is characterized by protrusion of the anterior vaginal wall within the genital opening.

The third degree is the most severe, it is diagnosed in any condition of the patient, even when she is at complete rest. In this case, the vaginal wall completely or partially extends beyond the genital opening.

It is worth paying attention to the fact that only if a cystocele is detected in the early stages, it will be possible to get rid of it without surgical intervention. Remember that it is possible to prevent bladder prolapse. To do this, you need to regularly go to a gynecologist for a scheduled appointment and examination.

Mechanism of the process of loss

It has been proven that during menopause the muscle tone of the pelvis decreases. The reasons for such consequences are both excessive physical activity and regular lifting of heavy loads. After loss of elasticity, internal organs are unable to stay in place and they become displaced. As the bladder descends, the patient experiences a feeling of pressure on the vagina. In medicine, this pathology is called “cystocele”.

Often this disease becomes the root cause of urinary incontinence. As it descends, the shape of the bladder becomes arched and the sphincters lose their location. As a result, they become unable to retain urine. With complete prolapse, the bladder becomes visible in the vagina. This stage of the disease is accompanied by absolute urinary incontinence.

Bladder prolapse is much less common in men than in women. The main causes of pathology are:

• Pregnancy and childbirth. During pregnancy, there is constant pressure on muscle tissue due to excessive expansion of the abdominal volume. As a result, the bladder is able to move into the vaginal cavity. Bladder prolapse in women occurs after the second or third natural birth. Another negative factor may be complicated childbirth. This pathology does not develop during caesarean section.
• Problems with excess weight. With this problem, the size of the abdomen also increases greatly. As a result, there is continuous pressure on the bladder muscles. The lowering of the bladder also progresses with sudden weight loss, which causes muscle weakening.
• Regular lifting of weights and participation in strenuous sports.
• Hereditary weakening of the muscular framework of the pelvis.
• Chronic constipation. If this problem is present, a woman will strain excessively during bowel movements, which leads to a weakening of muscle tone.
• The presence of chronic cough (including in smokers). During a strong cough, not only the chest organs are stressed, but also all other internal organs of a person. This process also has a strong impact on the pelvic area.
• Climax. During this period, the female body goes through a stage of hormonal changes, which helps to reduce estrogen levels and weaken the muscular system.
• Internal pressure on the bladder area due to pathological processes (tumor, enlarged lymph nodes).
• After removal of the uterus, complete prolapse of the bladder is observed.

The age of the patient is also very important. Most often, women over 40 years of age suffer from the disease.

Basic diagnostic methods

As a rule, such problems are visible during the initial examination by a gynecologist. This is why it is so important to undergo routine examinations with all specialists. Next, you may need to consult a urologist, proctologist and surgeon. The diagnosis of cystocele is made based on the patient’s complaints, medical history and examination, as well as after research.

Apply:

1. Ultrasound and MRI examination.
2. X-ray with the introduction of a special contrast agent.
3. They look at the dynamics of urine outflow.
4. Cystoscopy is performed. So that other bladder problems can be identified.
5. If necessary, blood and urine tests are taken.

• Anterior prolapse - CYSTOCELE - protrusion of the bladder through the anterior wall of the vagina.
• Posterior prolapse - RECTOCEL - protrusion of the rectum through the posterior wall of the vagina.
• Apical prolapse - HYSTEROPTOSIS - prolapse of the uterus from the vagina with simultaneous prolapse of both the anterior and posterior fornix and vaginal walls.

In domestic medicine, the generally accepted classification of pelvic organ prolapse (according to K.F. Slavyansky):

• I degree. Prolapse of the anterior and/or posterior walls of the vagina (the walls do not extend beyond the entrance to the vagina);
• II degree. Prolapse of the anterior and/or posterior walls of the vagina (the walls are located outward from the entrance to the vagina);
• III degree. Complete vaginal prolapse, which is accompanied by uterine prolapse.

Symptoms

You can determine the presence of such a disease in yourself by a number of symptoms that are permanent, but the diagnosis must be made by the attending physician. Obvious symptoms include:

1. Involuntary urination when coughing, laughing, sneezing, during stressful situations.
2. Frequent urge to urinate.
3. A feeling of pain localized in the back, lower abdomen, in the vaginal area (it can go away if you take a lying position) and discomfort during sexual intercourse.
4. During the examination, the doctor diagnoses a protrusion of the bladder into the vagina.
5. Feeling of incomplete bowel movement.
6. Infectious diseases occurring in the genitourinary system (cystitis is most often noted).

Prevention

To avoid the occurrence of this disease, a woman needs to visit a gynecologist every six months, especially for those young ladies who have given birth more than 2 times. If a genetic predisposition appears, it is recommended to perform simple exercises aimed at strengthening muscles and increasing their tone; lifting weights or being overly involved in sports and fitness is prohibited.

In addition, experts say that in the case of weight loss, the process of losing weight should not be rapid, but gradual. To minimize the risk of constipation and normalize intestinal activity, it is recommended to include more fresh vegetables and prunes in your diet.

Symptoms and treatment for bladder prolapse can be very different, but in any case, this disease must be diagnosed at an early stage. This is the only way a woman will be able to maintain her health and receive adequate help.

Cystocele can be avoided quite effectively if you devote time to prevention. A woman can protect herself from this unpleasant and painful illness if she follows a few simple rules.

You should regularly perform Kegel exercises, especially with the onset of advanced age, do not lift weights, treat constipation in a timely manner, do not develop diseases that provoke a severe cough, control your weight, regularly go to the gynecologist for preventive examinations, even if nothing bothers you.

Causes of the disease

There are many factors that can provoke bladder prolapse. They negatively affect the condition of the organ itself, muscles and ligaments. Prolapse and prolapse of the bladder can develop in a person for the following reasons:

• One of the most common factors that causes bladder prolapse is a disturbance in the level of hormones in the female body. In most cases, hormonal imbalance is a consequence of improper restructuring of the body, and this pathology is mainly diagnosed in patients during the natural decline of reproductive function, that is, during menopause. In a woman, the production of estrogen in the body sharply decreases, and the consequence of this is a weakening of muscle tone;

cystocele is often detected in mothers after pregnancy and childbirth with various complications. This is explained by the fact that during childbirth there is a strong stretching of the vaginal walls, ligaments and muscles of the pelvis, which causes their deformation. In fact, this pathology is most often diagnosed in those women who gave birth naturally;

• Excessive physical activity and heavy lifting can cause bladder prolapse. All this negatively affects a woman’s body and can result in bladder prolapse;
• Not the least place in the development of such a disease belongs to heredity, that is, the tendency to such an anomaly can be transmitted from parents to children. Pathology can begin to progress with congenital abnormalities in the structure of the organs of the genitourinary system;
• Problems with the digestive system can cause organ prolapse. The main cause of the development of the disease is constant constipation, which is accompanied by an increase in the tone of muscle tissue during the act of defecation. It is for this reason that it is important to monitor your diet and control your bowel movements.

Excess weight and obesity can also cause the development of a disease such as cystocele.
However, sudden weight loss, like extra pounds, can provoke bladder prolapse. The progression of this disease can be observed after operations on the pelvic organs. Often the pathological process is observed with tumors of various nature that appear in the genitourinary system. Both benign neoplasms and cancerous tumors can cause the disease.

Hormone therapy

With conservative treatment, you will be prescribed hormonal therapy and special Kegel exercises, but this is only possible in the early stages of the disease.

At this stage, hormonal therapy has long proven its effectiveness, which allows you to restore the level of specific female sex hormones called estrogens. They have a direct impact on the tone and condition of the pelvic floor muscles. You should not choose medications yourself; this should be done by a doctor, after assessing all the factors and risks.

Hormone therapy is prescribed after examination and determination of a deficiency of hormones produced by the woman’s own ovaries. The mucous membranes of such patients become dry, bloodless, bleed easily and become inflamed.

Timely hormonal therapy improves the musculoskeletal system of the pelvic organs, increases the tone of the walls and restores the functions of the vaginal glands, strengthens the immune system.

Contraindications for hormonal therapy are the presence or high risk of developing malignant tumors of the genital area.

Physiotherapy

Performing exercises with a prolapsed bladder is justified only at the first stage of the disease. They strengthen the vaginal wall and prevent further development of pathology.

Exercises developed by Kegel are often used. To do this, a woman needs to rhythmically squeeze and unclench the muscles of the intimate area. At first, gymnastics is performed slowly, but gradually the speed increases. At the last stage, 3-4 strainings are performed.

This gymnastic complex takes 3-4 minutes and does not require much effort. Number of repetitions: 10–15. Tension and relaxation time: 3–10 seconds. It is carried out three times a day, every day.

In addition to Kegel exercises, therapeutic exercises are also used. This complex is prescribed by a doctor and is prohibited for independent use. Each movement should be measured and not cause much tension. In the case of the correct selection of exercises, not only the pelvic muscles are strengthened, but the activity of the internal organs is also normalized. They will also help you lose extra pounds.

Description of exercises

In the early stages, special exercises help many people. In this case, bladder prolapse can be effectively managed without resorting to dangerous surgical interventions.

This gymnastics is also considered the most effective preventive method. With the help of special exercises, the patient is able to restore normal tone to the intimate and pelvic muscles. Many people are attracted to them by the fact that to perform them it is not at all necessary to visit a clinic or go to the gym. The entire complex is available at home.

Important: Kegel exercises must be performed with an empty bladder. It will be especially effective if you do all the exercises lying on your back with your knees bent.

Squeeze the muscles, pulling your knees up, hold them in this position for ten seconds, then relax the muscles for 10 seconds, repeat all over again. It is recommended to perform this complex 10 times in the morning, afternoon and evening.

Please note that while performing the exercises, you should not hold your breath or stretch your navel. Everything should be done as smoothly as possible, breathe calmly and deeply and not overload the body with these workouts - 10 repetitions in one approach will be quite enough. Muscle strengthening should occur in about two to three months, and the uterus will return upward to its normal position.

Treatment of the disease

Treatment of bladder prolapse begins immediately after confirmation of the diagnosis.
The doctor decides how to treat such a pathology, taking into account the stage of the disease and the general condition of the patient. If the pathology is at the very beginning of development, conservative methods are used to eliminate it. Such therapy includes performing therapeutic exercises, using a pessary and a bandage. Such treatments help return the bladder to its normal position and alleviate the patient's condition. When cystocele passes into an advanced form, they resort to antibacterial agents and various hormones.

A vaginal pessary is a special device that is placed in the vaginal area. With its help, it is possible to return the pelvic organs to their original place and prevent the problem from worsening.

This option is considered a good alternative to surgical treatment of bladder prolapse in women, but before wearing a pessary, you should consult a specialist.

The condition of muscles and ligaments is affected by the estrogen content in the body, therefore, for cystocele, this hormone is prescribed. Treatment is carried out under the supervision of a doctor, since any fluctuations in hormone levels can lead to unpleasant consequences. Estrogens in the form of creams are no less dangerous for the body than tablets.

If the bladder prolapses and problems with urination occur, antibacterial therapy may be prescribed. With its help, it is possible to stop the inflammatory process, which often develops when the organ prolapses.

For cystocele, drug treatment is recommended to be combined with Kegel exercises and gymnastics for bladder prolapse in women. With their help, it is possible not only to eliminate cystocele, but also to get rid of pain.

In the treatment of bladder prolapse, the use of a bandage is practiced, wearing which helps to normalize the position of this organ and the uterus if there are contraindications to the operation. This special device relieves pain and discomfort and speeds up the patient’s rehabilitation.

In situations where conservative treatment does not bring the desired result, surgery is resorted to. When it is carried out, the organ is tightened, and the development of dangerous complications is avoided.

Surgical removal of cystocele is performed laparoscopically and using anterior colporrhaphy. Thanks to them, the bladder is tightened and its correct anatomical position is restored.

Surgical restoration with one's own tissue (colporrhaphy)

If the disease has progressed to the third stage, surgery cannot be avoided when the bladder prolapses. When developing the right tactics for surgical intervention, the doctor must understand what exactly is causing the weakening of your pelvic muscles.

To do this, a preliminary comprehensive diagnosis is carried out with the involvement of the necessary specialists in related fields. The degree of surgical intervention is influenced by the degree of prolapse of the bladder, age, possible pathologies of neighboring organs, and many other important factors.

It is worth remembering that effective treatment of this disease can only be provided by a comprehensive and professional approach to solving the problem. Indeed, the relaxation of the muscles that influence the development of this pathology is based on a complex of different reasons.

The patient must be sure that he is in the hands of professional surgeons who work with modern equipment.

During the operation, excess vaginal mucosa is removed, after which the wound is sutured. The suture is placed in such a way as to fix the bladder (with anterior colporrhaphy) and the rectum (with posterior colporrhaphy) in the correct position.

Access is performed through the vagina, the suture is not visible from the outside. The tutorial is simple and takes about 30 minutes. Efficiency – 80 percent.

Colporrhaphy is offered to young and relatively young women who are planning a pregnancy. The key conditions are the preservation of vaginal tissue and healthy hormonal levels. After 50 years, plastic surgery using one’s own tissues is rarely performed. During menopause, the effectiveness is significantly lower - the altered tissues are not suitable as a “building” material.

Disadvantages: high risk of recurrence (up to 30 percent), in which case the prolapse is re-corrected with a synthetic implant (OPUR).

ethnoscience

When carrying out conservative therapy, you can additionally use traditional medicine to improve the condition.

Folk remedies are intended to reduce the intensity of pain and relieve inflammation.

The most common recipes:

1. 1. Squeeze the turnip juice and cook it for 5 minutes. The resulting drink should be drunk 3 times a day, 2 tablespoons.
2. 2. Take carrot tops, rinse, chop and brew a small handful of 500 ml of boiling water. Leave for an hour and drink 3 hours before meals. You can prepare an effective remedy based on tops and parsley. In this case, the components are taken in equal proportions, boiled and taken in an identical manner.
3. 3. Milk with tar. It is necessary to add 10 g of birch tar to a glass of warm milk. The drink should be drunk throughout the day, divided into 3 doses.
4. 4. Pine nuts. This is a universal remedy for bladder diseases. They can be consumed by stirring them in honey.
5. 5. Celery seeds and honey. You need to take the components in equal proportions, mix and eat 1 spoon 3 times a day.
6. 6. Olive oil. Half an hour before meals you need to drink 1 spoon of oil.
7. 7. Decoction of unpeeled oats. Recipe: take 1 glass of raw material, add water and cook in a water bath until the mixture is reduced by half in volume. Afterwards you need to strain the drink, dilute with a couple of tablespoons of honey and heat over low heat for 5 minutes. It is recommended to drink the resulting product half a glass 3 times a day.
8. 8. Mash parsley seeds (1 tbsp) and pour in 500 ml of boiled water. Leave overnight. In the morning you need to strain the juice and drink it throughout the day in 5 doses. If you don’t want to wait until the next day, you can grind the raw material into a powder and eat it. It is recommended to do this 4 times a day.
9. 9. Infusion of yarrow. It has pronounced anti-inflammatory and hemostatic effects. A healing remedy is prepared by brewing 250 ml of boiling water and 1 spoon of herbs. After 30 minutes of infusion, the drink is filtered and taken before meals 3 times a day.
10. 10. Green tea. It contains catechins, which have an anti-inflammatory effect. You need to drink it 3-4 times a day.
11. 11. Quince tea. It helps strengthen the muscles and ligaments of the pelvic organs. To prepare, you need to dry the fruits of the plant, grind them to a powder and season with boiling water in a ratio of 1:10. Then you need to cook in a water bath for 20-30 minutes, pour into a thermos and leave to infuse for several hours.
12. 12. Tincture of astragalus root. The recipe is identical to quince tea. You need to take it 1 tsp, diluted with water before meals.

To reduce pain and relieve inflammation, you can do douching. To do this, use solutions:

1. 1. Take 1 tbsp. l. dried viburnum berries, pour a glass of boiling water and leave for 30 minutes in a thermos. After cooling the solution to a comfortable temperature, irrigate the vagina with it.
2. 2. Datura infusion. Take 20 g of dry herb, pour 5 liters of boiling water, insulate the container and leave for 2 hours. Pour the resulting infusion into a bath and sit in it for about 15 minutes (the water temperature should not be higher than 38 degrees). This will strengthen your pelvic floor muscles.

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Conservative methods help curb the development of pelvic prolapse

Non-surgical methods are effective only in the initial stages of pelvic prolapse, when the prolapse is minor, and the resources of your own tissues (muscles, ligaments, supporting tissues of the vagina) allow them to be stimulated and trained.

Conservative therapy includes special gymnastics to develop the muscles and ligaments of the pelvic floor, as well as hormonal therapy to improve their elasticity.

For muscle training, Kegel exercises, exercises with balls, the “bicycle” exercise (in a supine position), exercises on the “step” simulator, swimming, etc. are recommended.

If muscle stimulation is not effective, it is possible to support the uterus with the help of a pessary - a silicone ring that is placed in the vagina. Pessaries are often used by women in old age, when surgical treatment is associated with a high risk.

Disadvantages: despite the variety of methods, conservative therapy does not stop the development of the disease.

General recommendations

In order to make treatment more effective and speed up the healing process, it is recommended to adhere to the following rules:

• Try to avoid any sports and intimate contacts during treatment. You can resume training only after your doctor’s permission.
• Adjust your diet. Eliminate fried and spicy foods, spices, vinegar and processed foods from your menu.
• Normalize the amount of vitamins: add plenty of fruits and vegetables. You can take pharmacy multivitamin complexes.
• Include prunes in your diet. It will improve the digestion process and prevent chronic constipation.

Following these recommendations does not require much effort, but the effect will be noticeable immediately.

Postoperative period

The duration of the postoperative period that the patient spends in the hospital depends on a complex of various factors. Including how successful the operation was and what condition the patient is in. On average, the rehabilitation period varies from one day to several days, since the operation is not classified as complex.

In this case, the patient must follow a number of recommendations for several weeks after surgery, no matter how successful your operation is. It is forbidden to cough intensively, lift heavy objects, sneeze frequently, stand in one place for a long time, have sex, or strain too hard during bowel movements. Any impact or strain on the muscles should be avoided.

As a rule, most restrictions are lifted after a month, at which time it is allowed to resume sexual relations with a partner.

Diagnosis of prolapse (prolapse) of the vagina, uterus and bladder

https://www.youtube.com/watch?v=xAwZC4ho49M

Many women in the early stages of pelvic organ prolapse do not experience symptoms. As the disease progresses, frequent or difficult urination and a feeling of incomplete emptying of the bladder appear. In addition to urological symptoms, there may be a sensation of a foreign body in the vagina, aching pain or a feeling of heaviness in the lower abdomen, constipation, gas incontinence, discomfort and pain during sex.

The doctor evaluates the structure of the walls and supporting apparatus of the vagina, the condition of the uterus and its cervix. They perform a general analysis and urine culture, smear culture, ultrasound of the pelvic organs, cystoscopy (examination of the bladder with a special thin instrument from the inside).

Urinary incontinence is checked by cough test. A woman on a gynecological chair with a full bladder, at the doctor’s command, begins to cough. If the resistance of the urethra due to weakened ligaments and excessive mobility is insufficient, then involuntary release of urine occurs. Sometimes the doctor simulates intra-abdominal pressure by pressing a tupfer (a clamp with a twisted cloth) on the bottom and back wall of the bladder.

If urination is significantly impaired, a complex urodynamic study (CUDI) is performed. They evaluate bladder function, tone, sensitivity and contractility of its walls. If there is significant prolapse of the bladder (grade 3 or higher), CUD is not performed, since the natural anatomy is disrupted.