In women, the front wall of the vagina supports the bladder. This wall weakens or loosens with age. Significant physical stress, such as childbirth, can also damage this part of the vaginal wall. If it is exhausted enough, the bladder can dilate, which means that it can no longer hold and descend into the vagina. It can trigger urinary problems, discomfort, and stress incontinence (for example, urine leakage caused by sneezing, coughing, and straining).

Dilated bladders (also known as collapsed bladders) are divided into four classes based on the distance between the bladder and the vagina.

• Grade 1 (mild): Only a small portion of the bladder falls into the vagina.
• Grade 2 (moderate): the bladder descends until it reaches the opening of the vagina.
• Grade 3 (severe): The bladder protrudes from the body through the vaginal opening.
• Grade 4 (complete): the entire bladder protrudes completely outside the vagina; It is usually associated with other forms of pelvic organ prolapse (cervical prolapse, rectocele, enterocele).

An enlarged bladder is generally associated with menopause. Before menopause, a woman's body produces a hormone called estrogen, which helps keep the vagina and surrounding muscles strong. After menopause, a woman's body stops making estrogen, and these muscles weaken as a result.

Causes of enlarged bladder

The following factors usually cause an enlarged bladder:

• Childbirth - This is a very common cause of an enlarged bladder. The birthing process involves pressure on the vaginal tissue and the muscles that support the female bladder.
• Menopause: The hormone estrogen, which helps maintain muscle strength and health in the vagina, is not produced after menopause.
• Straining: Lifting heavy objects, straining during bowel movements, having a chronic cough, or chronic constipation can damage your pelvic floor muscles.

Symptoms of enlarged bladder

The first symptom that women with an enlarged bladder usually notice is the presence of tissue in the vagina that most women feel like a ball.

Other symptoms of an enlarged bladder include the following:

• Pelvic discomfort or pain
• Tissue sticking out of the vagina (the tissue may be soft and bleed).
• Difficulty urinating
• Feeling that the bladder is not empty immediately after urination (incomplete urination)
• Stress incontinence (sneezing, coughing, or leaking urine during exertion)
• More frequent bladder infection
• Traumatic sexual intercourse (dyspareunia)
• Pain in the lower back

When to seek medical attention for an enlarged bladder

Any woman who notices symptoms of an enlarged bladder should see her doctor. An enlarged bladder is generally associated with the enlargement of other organs in the female pelvis. Therefore, prompt medical attention is recommended to assess and prevent troublesome symptoms and complications caused by the weakening of the vaginal tissues and muscles. Enlarged organs cannot heal on their own and become very serious over time. There are several treatments available to correct an enlarged bladder.

Exams and Tests for Enlarged Bladder

A gynecological and pelvic exam is called a pelvic exam to diagnose an enlarged bladder. The bladder entering the vagina confirms the diagnosis.

In less obvious cases, the doctor may use avoiding cystometrogram to help with the diagnosis. Cystothyrogram prevention is a series of x-rays taken during urination. These help the doctor determine the shape of the bladder and the cause of urination. The doctor may also examine or take X-rays of various parts of the abdomen to rule out other causes of discomfort or urination.

After diagnosis, the doctor will examine the severity of the nerve, muscle, and urinary flow and help determine what type of treatment is appropriate.

The test may be called urodynamic or video urodynamic at the discretion of the physician. These tests are sometimes called a "bladder ECG." Urodynamics measures pressure and volume relationships in the bladder and can be crucial in the urologist's decision.

A cystoscopy (looking at a range within the bladder) may also be done to identify treatment options. This test is a patient office procedure that is sometimes displayed on a television screen so that the person can see what the urologist is looking at. Cystoscopy has a lower risk and is more affordable for most people.

Treatment of enlarged bladder

Mild (grade 1) enlarged bladder does not cause pain or discomfort and usually does not require medical or surgical treatment. A physician may recommend that a woman with grade 1 bladder enlargement avoid heavy lifting or straining, although there is little evidence to support this recommendation.

For more severe cases, the doctor takes into account several factors, such as the woman's age, general health, the priority of treatment, and the severity of the bladder, to determine which treatment is appropriate.

Non-surgical treatments for an enlarged bladder include the following:

• Requirement: A device that is placed inside the vagina to hold the bladder in place. Those that are necessary to prevent infection should be removed and cleaned. Some pessaries are designed to be made for the woman herself. A doctor must remove and clean other types. Estrogen cream generally helps prevent infections and erosion of the vaginal wall along with pus. Some women find what they need is uncomfortable or that they come out easily.
• Estrogen Replacement Therapy - Many women with an enlarged bladder can benefit from this treatment. Estrogen helps to strengthen and maintain the muscles of the vagina.

Expand bladder care at home

For mild to moderate cases of bladder enlargement, your doctor may recommend changes in activities such as heavy lifting or straining. Dr. Kegel exercises may also be recommended. These are exercises that are used to tighten the pelvic floor muscles. Kegel exercises can be used to treat mild to moderate prolapse or to replace other therapies for more severe prolapse.

Medications for enlarged bladder

Estrogen replacement therapy can be used for an enlarged bladder to help the body strengthen the tissues in and around the vagina. Not everyone can use estrogen replacement therapy (in people with certain types of cancer). A woman's body stops producing estrogen naturally after menopause, and the muscles in the vagina can weaken as a result. In mild cases of bladder enlargement, estrogen is prescribed in an attempt to reverse the symptoms of bladder prolapse, such as vaginal weakness and incontinence. For more severe degrees of prolapse, estrogen replacement therapy can be used in conjunction with other types of treatment.

Estrogen can be given by mouth as a pill or as a topical patch or cream. The cream has a very low systemic absorption and has a powerful effect when applied topically. Topical administration is less risky than oral preparations. Using estrogens for the anterior vaginal and bladder area is very helpful in relieving symptoms, relief, and frequency of the bladder.

Enlarged bladder surgery

Very enlarged bladders that cannot be maintained with pus usually require surgery to correct them. Dilated bladder surgery is usually done through the vagina and the goal is to keep the bladder in its correct position. The expanded area is closed and the wall is reinforced.

Depending on the procedure, the surgery can be performed while the woman is under general, regional, or local anesthesia. For minor surgeries, most women go home the same day as surgery.

Various substances have been used to strengthen pelvic weakness associated with an enlarged bladder.

The FDA says that the risks of placing a mesh through the vagina to repair pelvic organ prolapse outweigh its benefits. However, in some cases the use of mesh is appropriate. A surgeon must describe in detail the risks, benefits, and potential problems of these substances and explain the procedure before surgery.

After surgery, most women expect to return to normal after six weeks. However, surgeons may recommend reducing or eliminating stressful activities for up to six months.

Another treatment for an enlarged bladder

Physical therapy, such as electrical stimulation and biofeedback, can be used for an enlarged bladder to strengthen the pelvic floor muscles.

Electrical stimulation: A doctor can apply a probe to specific muscles inside the vagina or pelvic floor. The probe is connected to a device that measures and sends out small electrical currents that contract the muscles. These contractions help strengthen muscles. Low intrusive electrical stimulation is available, which magnetically stimulates the pudendal nerve from outside the body. Activates the pelvic floor muscles and helps with incontinence.

Biofeedback: A sensor used to monitor muscle activity in the vagina and pelvic floor. Your doctor may recommend exercises that strengthen these muscles. These exercises can help strengthen muscles or relieve certain bladder symptoms. The sensor can monitor muscle contractions during exercises, and the doctor can determine if the target muscles are benefiting from the exercises.

Prevention of enlarged bladder

 To prevent bladder enlargement, a high-fiber diet, and daily intake of plenty of fluids can reduce the risk of constipation. Avoid straining during bowel movements if possible. Women suffering from chronic constipation should seek medical help to reduce the chance of developing a bladder.

Heavy lifting is associated with an enlarged bladder and should be avoided if possible.

 It is a residual risk factor for developing an enlarged bladder. The weight control can help prevent the development of this condition.

Out look for an enlarged bladder

 An enlarged bladder is rarely a malignant condition. Most mild cases can be treated without surgery, and very severe bladder enlargement can be completely corrected with surgery.

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