Anterior Prolapse

Anterior Prolapse

Overview

Anterior prolapse (known as anterior vaginal prolapse in women) or prolapsed bladder occurs when the bladder descends from its position and pushes on the vaginal walls or the pelvic floor muscles. This happens when the pelvic floor becomes weak or if sudden pressure is put on them, commonly during childbirth or heavy lifting. Mild to moderate cases of anterior prolapse can be treated non-surgically. In more severe cases, surgical intervention may be required to repair the prolapse.

Signs and symptoms

Mild cases of anterior prolapse may not present with any symptoms at all. If symptoms occur, they may include pressure in the pelvis or vagina, especially while coughing or lifting heavy objects and strain while urinating. Patients may have a hard time maintaining a steady stream of urine or struggle with urinary incontinence. Symptoms may appear to go away when you lie down and become more pronounced while standing for long periods of time. The patient may be susceptible to frequent urinary tract infections.

Causes

Anterior prolapse occurs when the bladder sinks due to weakness or trauma to the pelvic floor muscles. The bladder sinks and causes a bulge in the vaginal wall. The stress to the pelvic floor could be caused by childbirth, heavy lifting, repeatedly strained bowel movements, violent coughing or being overweight.

Risk factors

Women who are overweight, pregnant women who have undergone multiple deliveries and post-menopausal women are at a higher risk of developing anterior vaginal prolapse. Having your uterus removed in a hysterectomy procedure could also weaken the pelvic floor muscles and increase your risk of an anterior prolapse, but that is not always the case.

Complications

An anterior vaginal prolapse can lead to urinary incontinence and significant pain during sexual intercourse.

Diagnosis

An anterior vaginal prolapse is diagnosed on the basis of a patient’s medical history and a physical examination. The doctor may also require the patient to undergo a urodynamics test to measure the bladder’s ability to hold and release urine and a cystourethroscopy to examine the urethra and bladder for blockages.

Treatment

Anterior prolapse may not require surgical treatment unless it is symptomatic. Mild cases can be treated with pelvic floor muscle exercises or a pessary. A pessary is a plastic or rubber ring inserted into the vagina to support the prolapse and relieve pain. A moderate to severe anterior prolapse will require reconstructive surgery to move the bladder into position. Post-surgical recovery usually takes four to six weeks.

Prevention

People at a high risk of developing anterior prolapse should refrain from heavy physical work and maintain a healthy body-mass index.

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