Do you want to skip to content? Skip to content
Convatec Group Contact Us Brasil Brasil United States (English) United States (English) Estados Unidos (Español) Estados Unidos (Español) Argentina Argentina Canada (English) Canada (English) Canada (Français) Canada (Français) Chile Chile Colombia Colombia Ecuador Ecuador México México Perú Perú Belize Belize Guyana Guyana Jamaica Jamaica Venezuela Venezuela Costa Rica Costa Rica Curaçao Curaçao República Dominicana República Dominicana Guatemala Guatemala Honduras Honduras Nicaragua Nicaragua Panamá Panamá Puerto Rico Puerto Rico Suriname Suriname El Salvador El Salvador United Kingdom United Kingdom France France Deutschland Deutschland Italia Italia Україна Україна België België Česko Česko Danmark Danmark España España Ireland Ireland Nederland Nederland Norge Norge Österreich Österreich Polska Polska Schweiz (Deutsch) Schweiz (Deutsch) Slovensko Slovensko Suisse (Français) Suisse (Français) Suomi Suomi Sverige Sverige Türkiye Türkiye Ελλάδα Ελλάδα Россия Россия Bosna i Hercegovina Bosna i Hercegovina България България Eesti Eesti Hrvatska Hrvatska Magyarország Magyarország Ísland Ísland Lietuva Lietuva Latvija Latvija Северна Македонија Северна Македонија Malta Malta România România Srbija Srbija Slovenija Slovenija الإمارات العربية المتحدة الإمارات العربية المتحدة البحرين البحرين مصر مصر ישראל ישראל ایران ایران الأردن الأردن عُمان عُمان قطر قطر پاکستان پاکستان لبنان لبنان الكويت الكويت المملكة العربية السعودية المملكة العربية السعودية Suid-Afrika Suid-Afrika العراق العراق New Zealand New Zealand 日本 日本 Australia Australia India India Malaysia Malaysia Singapore Singapore 대한민국 대한민국 中国大陆 中国大陆 中国台湾 中国台湾 ไทย ไทย Indonesia Indonesia Việt Nam Việt Nam Philippines Philippines Hong Kong SAR China (English) Hong Kong SAR China (English) 中国香港特别行政区 (中文(简体,中国香港特别行政区)) 中国香港特别行政区 (中文(简体,中国香港特别行政区))
False /oidc-signin/en-us/ Convatec Group Contact Us Brasil Brasil United States (English) United States (English) Estados Unidos (Español) Estados Unidos (Español) Argentina Argentina Canada (English) Canada (English) Canada (Français) Canada (Français) Chile Chile Colombia Colombia Ecuador Ecuador México México Perú Perú Belize Belize Guyana Guyana Jamaica Jamaica Venezuela Venezuela Costa Rica Costa Rica Curaçao Curaçao República Dominicana República Dominicana Guatemala Guatemala Honduras Honduras Nicaragua Nicaragua Panamá Panamá Puerto Rico Puerto Rico Suriname Suriname El Salvador El Salvador United Kingdom United Kingdom France France Deutschland Deutschland Italia Italia Україна Україна België België Česko Česko Danmark Danmark España España Ireland Ireland Nederland Nederland Norge Norge Österreich Österreich Polska Polska Schweiz (Deutsch) Schweiz (Deutsch) Slovensko Slovensko Suisse (Français) Suisse (Français) Suomi Suomi Sverige Sverige Türkiye Türkiye Ελλάδα Ελλάδα Россия Россия Bosna i Hercegovina Bosna i Hercegovina България България Eesti Eesti Hrvatska Hrvatska Magyarország Magyarország Ísland Ísland Lietuva Lietuva Latvija Latvija Северна Македонија Северна Македонија Malta Malta România România Srbija Srbija Slovenija Slovenija الإمارات العربية المتحدة الإمارات العربية المتحدة البحرين البحرين مصر مصر ישראל ישראל ایران ایران الأردن الأردن عُمان عُمان قطر قطر پاکستان پاکستان لبنان لبنان الكويت الكويت المملكة العربية السعودية المملكة العربية السعودية Suid-Afrika Suid-Afrika العراق العراق New Zealand New Zealand 日本 日本 Australia Australia India India Malaysia Malaysia Singapore Singapore 대한민국 대한민국 中国大陆 中国大陆 中国台湾 中国台湾 ไทย ไทย Indonesia Indonesia Việt Nam Việt Nam Philippines Philippines Hong Kong SAR China (English) Hong Kong SAR China (English) 中国香港特别行政区 (中文(简体,中国香港特别行政区)) 中国香港特别行政区 (中文(简体,中国香港特别行政区))

Urinary Retention – Pelvic Organ Prolapse

Our professional content originates from Melissa Fulton, RN, BSN, MSN, FNP, APRN-C, Certified MS Specialist and other healthcare contributors.

Often healthcare providers think of incomplete bladder emptying as a male urological problem however, women can suffer from structural abnormalities that contribute to incomplete bladder emptying as well.

When the pelvic floor becomes lax due to childbirth, weight gain, pushing due to constipation, etc – there is a risk that the bladder, intestines, uterus, or rectum may fall into the vaginal vault. This pelvic organ prolapse may put pressure on the urethra and/or the bladder. It can also kink the urethra – preventing the bladder from emptying to completion.1

When a female presents to your clinic with complaints of slow urinary stream or describing a feeling that "... something is coming out of my vagina not allowing my bladder to empty” – think pelvic organ prolapse.

Usually, a woman with these complaints may be:

  • In childbearing years
  • Post-menopausal
  • Has had previous surgical intervention to the vaginal vault – such as a hysterectomy

A woman can have a single organ prolapse or multiple organs prolapsing at one time. Either way, the patient may experience incomplete bladder emptying, recurrent urinary tract infections, and/or dyspareunia (painful intercourse).2

An easy visual for patients to help them understand organ prolapse.

“You have a trampoline holding up the anterior wall or upper wall of the vagina which supports the bladder; a trampoline at the top or apex of the vagina which supports the uterus and intestines; and a trampoline on the back wall of the vagina that holds the rectum in place.

Weakness to any of these trampolines could cause sagging or prolapse of pelvic organs into the vaginal vault. The organ prolapsing into the vaginal vault may lead to obstruction."

Vaginal prolapse or loss of the integrity of the vaginal walls can result in defects referred to as cystoceles, rectoceles and enteroceles.

 

diagram ;

A cystocele is the loss of support of the anterior vaginal wall often related to childbirth or weight gain. This muscle weakness allows the bladder to fall into the vaginal vault and potentially pinch off the urethra – making it difficult for the bladder to empty.3

A rectocele is a weakness of the posterior vaginal wall often related to constipation. This weakness can create pressure on the urethra and make it difficult to pass urine.1,4

Lastly, an enterocele is a vaginal wall weakness often caused by some sort of vaginal surgery. This weakness allows the small bowel to migrate into the vaginal vault, from the superior aspect of the vagina, often kinking the urethra and not allowing the bladder to empty.1,5

Each of these defects can affect the positioning of the urethra resulting in the inability to completely empty the bladder. A pelvic exam can help identify and confirm pelvic floor prolapse.

 

Incomplete bladder emptying can be confirmed using a bladder scan. If there is evidence of incomplete bladder emptying and patient’s symptoms are consistent with an obstructed voiding pattern, then there are a few clinical procedures which may confirm that treating the vaginal prolapse would improve bladder emptying.

A provider could place a pessary in clinic. Fill the bladder up with approx. 350 ccs of Normal Saline using a catheter, remove the catheter and then have the patient void. Repeat the bladder scan and see if the bladder empties to completion and voiding symptoms improve.

Urodynamics can also be completed to obtain this information. If the bladder empties more easily and voiding symptoms improve, then the focus should be on treating the pelvic organ prolapse.

There are times when intermittent catheterization may be necessary to assist in bladder emptying – short term, while other interventions are in process, or as a long-term solution if that is in the patient’s best interest.

Surgery may be necessary to treat patients who are reasonable candidates. Reconstruction of the vaginal vault would hopefully provide adequate support improving bladder emptying.

Conservative interventions may include weight loss, physical therapy to help strengthen the vaginal vault, use of a pessary to alleviate the prolapse, or possibly manual manipulation of the prolapse to allow the bladder to empty.

References: 1. https://www.mayoclinic.org/diseases-conditions/pelvic-organ-prolapse/symptoms-causes/syc-20360557 2. https://www.urologyhealth.org/urology-a-z/b/bladder-prolapse-(cystocele) 3. https://my.clevelandclinic.org/health/diseases/15468-cystocele-fallen-bladder 4. https://my.clevelandclinic.org/health/diseases/17415-rectocele 5. https://my.clevelandclinic.org/health/diseases/16966-enterocele

Related Articles

Related Articles

Urinary Retention – Pelvic Floor Dysfunction

Another source of urinary retention, which can affect both men and women, includes pelvic floor dysfunction (PFD). The diagnosis of PFD is not always easy. Obtaining a good health history from the patient is important.

Read more

Related Articles

Catheter Selection

When navigating intermittent catheter selection for patients, finding a product that will help them stay compliant to their prescribed cathing regimen is key. To ensure optimized patient outcomes, you’ll want to consider:

Read more

Related Articles

Neurogenic Bladder - Multiple Sclerosis

Multiple Sclerosis or MS is a disease in which the immune system attacks the brain, spinal cord, and optic nerves resulting in the destruction of myelin (the protective covering of nerves). Think of it as an electrical cord losing its outer covering and the inner wires are exposed. The result can be an interruption in appropriate signals in the nervous system.

Read more

Enroll your patients in me+™ or Request product samples

The me+™ support program offers your patients tools to help make their life as a catheter user completely their own. Enroll your intermittent catheter patients in me+™ or request free product samples. Empower your patients to experience the latest technology and discover answers to the most commonly asked cathing questions.

From a wide range of product solutions to educational tools and resources, we're here to help support you and your patients.

Speak with a member of the me+™ support team today.

Call 1-800-422-8811 (M-F, 8:30 AM-7:00 PM ET).

Contact us

You are leaving convatec.com

This Internet site may provide links or references to other sites but Convatec have no responsibility for the content of such other sites and shall not be liable for any damages or injury arising from that content. Any links to other sites are provided as merely a convenience to the users of this Internet site.

Do you wish to continue?

Support
Contact Us
Convatec is committed to always showing the latest information and data, so our web pages are continually reviewed and updated to ensure they have the most current and relevant information