The bladder is a hollow, muscular organ in the pelvic region that stores urine. Its walls stretch to accommodate fluid and contract to release it. The bladder’s position is not entirely fixed, as it is held in place by a network of pelvic floor muscles and ligaments that allow for movement.
Normal Bladder Location in the Pelvis
The bladder is situated low in the abdomen, protected within the pelvic cavity and positioned behind the pubic bone. Its location differs between the sexes. In individuals assigned female at birth, the bladder sits in front of the uterus and vagina. For those assigned male at birth, it rests superior to the prostate gland and in front of the rectum.
The position of the bladder is also dynamic, changing in response to its volume. When empty, it is a smaller organ deep within the pelvis. As it fills with urine, it expands upward into the lower abdominal cavity and can hold around 500 to 700 milliliters.
What Causes the Bladder to Change Position?
The bladder’s stability depends on the pelvic floor muscles and connective tissues, which function like a supportive hammock for pelvic organs. A change in the bladder’s position is caused by the weakening or stretching of this support system. When these muscles and tissues lose strength, they can no longer provide adequate support.
Several factors can weaken the pelvic floor. Pregnancy and vaginal childbirth are common causes, placing significant stress on the pelvic muscles. The aging process and hormonal changes associated with menopause can also lead to a loss of tissue elasticity. Other causes include chronic strain from heavy lifting, a persistent cough, or long-term constipation.
Bladder Prolapse and Associated Symptoms
When the supportive wall between the bladder and vagina weakens, it can lead to bladder prolapse, or cystocele. This occurs when the bladder droops from its correct position, creating a bulge into the vaginal canal. The severity is graded, with a mild prolapse involving a small drop into the vagina and a severe case involving the bladder protruding through the vaginal opening.
Common symptoms include a sensation of pressure, fullness, or heaviness in the pelvic and vaginal area. Some people describe a feeling like sitting on a small ball or may see or feel a tissue bulge from the vaginal opening.
Urinary symptoms are also frequent and include:
- Stress incontinence, the leakage of urine during activities like coughing, sneezing, or laughing
- A frequent or urgent need to urinate
- Difficulty starting a stream of urine
- A feeling that the bladder is not emptying completely after urination
- Discomfort during sexual intercourse
- An increased frequency of urinary tract infections