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How is Bladder Prolapse Treated?

Conservative Management

Conservative measures involve

  1. No treatment. Some women have bladder prolapse and do not have bothersome symptoms. You do not need to treat your prolapse if it is:
  • not causing you problems
  • not blocking your urine flow

2. Behavior therapy this can include:

  • kegel exercises (which help strengthen pelvic floor muscles)
  • pelvic floor physical therapy
  • a pessary (a vaginal support device)

3. Drug therapy this includes:

  • estrogen replacement therapy

Surgery

The goal of surgery is to repair your body and improve symptoms. Surgery can be performed through the vagina or the abdomen. There are several ways the surgery can be done, they include:

  • Open surgery- when an incision (cut) is made through the abdomen
  • Minimally invasive surgery- uses small incisions (cuts) in the abdomen
  • Laparoscopic- the doctor places surgical instruments through the abdominal wall
  • Robot-assisted laparoscopic- robotic instruments are placed through the abdominal wall. They are attached to robotic arms, and are controlled by the surgeon.

Surgery also involves options of:

  • native tissue repair (using one's own tissue and sutures)
  • augmentation with surgical material
    • polypropylene mesh
    • biological graft

Before having surgery you should have an in-depth talk with your surgeon. You should learn about the risks, benefits, and other choices for repairing cystocele with surgery. It is important that you give informed consent. This can only be done after your doctor has answered all of your questions.

If prolapse is left untreated, over time it may stay the same or slowly get worse. In rare cases, severe prolapse can cause obstruction of the kidneys or urinary retention (inability to pass urine). This may lead to kidney damage or infection.