Bladder prolapse, or cystocele, is a common problem postpartum and often years later. When the bladder drops into the vaginal space, it weakens the pelvic floor due to increased pressure and can cause urinary incontinence. Additionally, since the bladder drops to a lower position in the pelvis, the urethra can often get "kinked" which results in post-void dribbling, or dribbling that occurs when you stand following urination. Fortunately, there ARE non-surgical ways to treat this problem!
Normally, the bladder rests directly above the pubic symphysis. You can actually palpate, or feel the bladder by first finding the pubic symphysis, or area where the two halves of the pelvis connect in front. The bladder should sit immediately above this bony area; you will feel a sense of urgency when it is palpated.
The key to non-surgically treating bladder prolapse is to get the bladder back into it's normal position and then strengthen the pelvic floor to allow the muscles to optimally acheive contraction without excess pressure. There are a handful of ways to do this. One of the best ways is to lie prone, or on your front. This allows gravity to pull the bladder to the front over the pubic bone and off the muscles of the pelvic floor. Another way is to position yourself on hands and knees. This also lets gravity do it's thing but gives you the additional freedom to do a "pelvic tilt" to facilitate the repositioning. Imagine that the pelvis is like a bowl of fruit and you are trying dump out the fruit. By "dumping the fruit out" you are also dumping the bladder into a more superior position and away from the pelvic floor. Finally, you can acheive bladder repositioning from a seated position. Sit on the edge of a chair and "dump the fruit out of your bowl." In PT terms, this is called an anterior pelvic tilt. You may lean your hands or elbows on your thighs in order to tilt your pelvis in this way.
This technique will only be successful IF AND ONLY IF you strengthen your pelvic floor while in these positions. Remember to do your kegels! For more information, please contact me or see a Physical Therapist who specializes in women's health!
