Bladder Prolapse in Hypermobile Ehlers-Danlos Syndrome

I woke up this morning with lower back pain, pelvic pressure, and difficulty emptying my bladder. For most people their mind would go to a uti. Not me, I have hEDS. My first thought, like so many of you was, oh no! My bladder prolapsed overnight! Unfortunately, with organ prolapse being significant in the hEDS community a bladder prolapse is not uncommon. Especially after hysterectomy, menopause, and/or child birth.

Bladder prolapse, also known as cystocele, is a condition where the bladder drops from its normal position and pushes against the vaginal wall. For people with hypermobile Ehlers-Danlos syndrome (hEDS), this issue can be more common and challenging due to the nature of their connective tissue disorder. Understanding how bladder prolapse relates to hEDS helps those affected recognize symptoms early and seek appropriate care.

Because connective tissue supports organs, including the bladder and pelvic floor, hEDS can increase the risk of pelvic organ prolapse, including bladder prolapse. The weakened support for structures in the pelvis allow the bladder to sag or bulge into the vaginal area.

How Bladder Prolapse Develops in hEDS

In a healthy body, ligaments and muscles hold the bladder in place. In hEDS, these tissues are more elastic and less strong. Over time, the pelvic floor muscles and connective tissues may stretch or weaken, especially with added pressure from activities like heavy lifting, chronic coughing, or childbirth.

This weakening causes the bladder to lose its normal position and push into the vaginal wall. The severity of prolapse can vary from mild to severe, sometimes causing discomfort or urinary problems.

Recognizing bladder prolapse early can prevent worsening symptoms. Common signs include:

• A feeling of fullness or pressure in the pelvis or vagina

• A bulge or lump in the vaginal area

• Difficulty starting urination or a weak urine stream

• Lower back pain

• Constant feeling of needing to urinate without being able to completely empty the bladder

• Frequent urinary tract infections

• Urinary leakage or incontinence

• Discomfort during sexual activity

  
  

People with hEDS might notice these symptoms more often due to their tissue fragility. If any of these signs appear, consulting a healthcare provider familiar with hEDS is important.

Managing Bladder Prolapse with hEDS

Treatment for bladder prolapse in hEDS focuses on relieving symptoms and preventing progression. Options include:

• Pelvic floor physical therapy: Specialized exercises strengthen the pelvic muscles, improving support for the bladder. Physical therapists trained in connective tissue disorders can tailor programs to individual needs.

• Lifestyle adjustments: Avoiding heavy lifting, managing chronic cough, and maintaining a healthy weight reduce pressure on the pelvic floor.

• Pessary devices: These are removable supports inserted into the vagina to hold the bladder in place. They can be a non-surgical option for symptom relief.

• Surgery: In severe cases, surgical repair may be necessary. However, surgery in hEDS patients requires careful planning due to tissue fragility and slower healing. Surgeons experienced with connective tissue disorders are essential.

  
  

Practical Tips for Living with Bladder Prolapse and hEDS

Managing bladder prolapse alongside hEDS involves daily care and awareness. Here are some practical tips:

• Practice pelvic floor exercises regularly, but avoid overstraining.

• Use gentle, low-impact activities like swimming or walking to stay active.

• Stay hydrated and maintain a diet high in fiber to prevent constipation, which can worsen prolapse.

• Wear comfortable clothing that does not put pressure on the abdomen or pelvis.

• Keep a symptom diary to track changes and share with your healthcare provider.

  
  

When to Seek Medical Advice

If you experience new or worsening symptoms of bladder prolapse, especially with hEDS, it is important to see a healthcare professional. Early diagnosis and management can improve quality of life and reduce complications.

Look for specialists familiar with both pelvic floor disorders and connective tissue conditions. They can provide personalized care and guide you through treatment options. I made my appointment today for evaluation!

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