UROLOGY · CONDITIONS
Bladder Prolapse
Descent of the bladder into the vaginal canal due to weakened pelvic floor support — causing urinary symptoms and a sensation of vaginal bulge. Correctable with surgery.
ABOUT THIS CONDITION
What is Bladder Prolapse?
A cystocele (bladder prolapse) occurs when the supportive fascia between the bladder and vaginal wall weakens, allowing the bladder to descend into the vagina. It is most common after vaginal childbirth and at menopause. Symptoms include pelvic pressure, a sensation of vaginal bulge, incomplete bladder emptying, and urinary incontinence. Dr. Vipin provides a comprehensive assessment of all pelvic floor compartments before recommending the most appropriate repair — conservative with a pessary, vaginal anterior colporrhaphy, or laparoscopic sacrocolpopexy for durable anatomical correction.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Vaginal childbirth — stretching and tearing of supports
- Menopause — oestrogen loss weakening pelvic floor
- Chronic straining from constipation or heavy lifting
- Obesity increasing abdominal pressure chronically
- Connective tissue disorders — Marfan, Ehlers-Danlos
- Hysterectomy disrupting apical vaginal support
CLINICAL DETAILS
KeyFacts
Prolapse is graded I–IV using the standardised POP-Q system before treatment planning.
Ring or shelf pessary supports the bladder non-surgically — suitable for women unfit for or declining surgery.
Anterior colporrhaphy is the standard vaginal repair for primary moderate cystocele.
Laparoscopic or robotic sacrocolpopexy provides gold standard apical support with mesh to the sacrum.
Coexisting stress incontinence can be addressed simultaneously with a mid-urethral sling.
Vaginal repair: 2–3 day hospital stay. Laparoscopic repair: 1–2 days. Pelvic rest for 6 weeks.
HOW WE TREAT IT
Treatment Approach
Laparoscopic Sacrocolpopexy
A mesh is sutured to the anterior vaginal wall and fixed to the anterior longitudinal ligament of the sacrum laparoscopically — providing durable apical and anterior support with low prolapse recurrence rates.
- 1
Assessment
POP-Q staging grades prolapse severity. Urodynamics assesses coexisting incontinence or bladder overactivity before planning repair.
- 2
Conservative First
Pelvic floor exercises and ring pessary support are offered as non-surgical options for mild to moderate symptomatic cystocele.
- 3
Surgical Repair
Anterior colporrhaphy (vaginal approach) or laparoscopic sacrocolpopexy (abdominal approach) selected based on grade, compartments involved, and patient preference.
- 4
Recovery
Catheter removed at 24–48 hours. Vaginal rest for 6 weeks. Pelvic floor physiotherapy commenced at 6 weeks to consolidate surgical repair.
AVAILABLE TREATMENTS
Treatment Options
Anterior + Posterior Colporrhaphy
Vaginal plication of the pubocervical fascia to repair the cystocele — standard surgical repair for primary anterior compartment prolapse.
Paravaginal Repair
Reattachment of detached lateral paravaginal fascia to the arcus tendineus — corrects the lateral defect causing bladder prolapse.
Open / Laparoscopic Sacrocolpopexy
Mesh sutured to the vaginal wall and fixed to the sacrum laparoscopically — gold standard for durable apical and anterior support.
Robotic Sacrocolpopexy
Robot-assisted sacrocolpopexy using da Vinci instrumentation — superior dexterity for mesh suturing in the deep pelvis.
COMMON QUESTIONS
Frequently Asked
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