Bladder lift surgery causes steps and possible complications

Bladder lift surgery has become one of the most common procedures among women, especially after multiple childbirths or with aging. Bladder prolapse or sagging can lead to uncomfortable symptoms like frequent urination, a constant feeling of pressure, or even difficulty performing daily activities.In this Dalili Medical article, we’ll walk you through everything you need to know about bladder lift surgery: When is it needed? How is it done? What are the potential risks? And how long does recovery take? Keep reading to gain a full understanding before making your decision.

Is Bladder Lift Surgery Really Effective?

The simple answer is: Yes.
Bladder lift surgery is considered highly successful, with a success rate of around 90% in most cases. However, it’s important to understand that the results may not always last a lifetime. In some cases, the bladder may prolapse again within 3 to 5 years, and a second surgery might be needed.

1. What is a "bladder lift"?

A bladder lift is a surgical procedure that restores the bladder to its natural position after it has dropped (prolapsed) due to weakened pelvic muscles. This often occurs due to multiple childbirths, aging, or chronic pressure on the pelvic area.

2. When do I need bladder lift surgery?

The procedure is necessary when:

There is a severe bladder prolapse
You experience bothersome symptoms like:
- Urinary incontinence (involuntary leakage)
- Pelvic pain or a feeling of pressure
- Frequent urination or difficulty urinating
Non-surgical methods (like exercises or pessaries) are not effective

3. Is bladder lift surgery painful?

The surgery is performed under general or spinal anesthesia, so you won’t feel any pain during the procedure.
After surgery, you might feel mild discomfort or pain for a few days, which usually improves quickly with rest and painkillers.

4. Is bladder lift surgery safe?

Yes, it’s a very safe procedure when performed by a skilled pelvic surgeon.
Like any surgery, there might be minor risks, such as:

Urinary tract infections
Mild bleeding
Temporary discomfort during intercourse

These complications are treatable and not very common.

5. How long is the recovery period?

Recovery depends on the type of surgery (laparoscopic or open), but generally:

You’ll need 2 to 6 weeks of rest.
Avoid heavy lifting or strenuous activities during the early phase.
You can usually resume your daily activities gradually after 2 weeks, if everything goes well.

6. Do I have to stop all activities after bladder lift surgery?

Not completely, but it’s very important to avoid:

Lifting heavy objects
Running or intense exercise
Sexual activity (until cleared by your doctor)

Rest is key for a smooth recovery.

7. Can the bladder prolapse return after surgery?

Yes, in some cases it can recur, especially if:

Post-surgery instructions are not followed
New pregnancy occurs
Pelvic tissues are too weak

That’s why follow-up with your doctor is crucial.

8. Will bladder lift surgery affect my sex life?

Most women return to normal sexual activity after healing.
However, you may notice:

Temporary discomfort
Slight change in sensation at first

These usually improve over time.

9. Are there non-surgical alternatives to treat bladder prolapse?

Yes, there are some options that can help before surgery, such as:

Kegel exercises: strengthen pelvic muscles and reduce symptoms
Support devices (pessaries): inserted into the vagina to hold the bladder in place
Medications: in specific cases, based on your doctor’s evaluation

However, for severe prolapse, surgery is often the best solution.

10. Will the surgery affect future pregnancy or childbirth?

If you’re planning to get pregnant, it’s important to discuss this with your doctor before surgery.
Usually, doctors recommend delaying pregnancy after surgery to avoid additional pressure on the bladder.

11. Does the surgery require full anesthesia?

In most cases, yes. The surgeon will use either:

General anesthesia (you’ll be fully asleep)
Or spinal anesthesia (numb from the waist down)

The choice depends on your condition and the surgical method.

12. Can the bladder lift be done using laparoscopy?

Yes! Laparoscopic or robotic-assisted surgery is a modern option.
Benefits include:

Less pain
Smaller incisions
Faster recovery

But it should be performed by an experienced surgeon in a well-equipped hospital or center.

13. Will I need a urinary catheter after surgery?

Yes, most patients need a temporary urinary catheter after the operation to:

Help with urination
Protect the healing bladder

It usually stays for 2 to 7 days, depending on your condition and doctor’s instructions.

14. Is the surgical mesh safe?

Most of the surgical meshes used are safe and effective, helping support weak tissues.
Rarely, they may cause:

Infections
Chronic pain
Irritation in nearby tissues

That’s why the surgeon chooses the most suitable type based on your case.

15. Can the surgery cause new urinary incontinence?

In rare cases, some women may experience new urinary incontinence after surgery.
But it’s usually manageable with:

Medications
Or pelvic floor exercises

16. Will bladder lift surgery affect bowel movement?

Normally, no. But you may experience:

Temporary constipation
Mild difficulty with bowel movements

This is due to anesthesia or reduced mobility and improves with time and proper diet.

17. Can physical therapy help before surgery?

Yes, for mild prolapse, pelvic floor therapy and Kegel exercises may improve symptoms and delay surgery.
Therapy focuses on:

Strengthening pelvic muscles
Better bladder control
Reducing discomfort

18. Could I need a second surgery if prolapse returns?

Yes, some women may need a repeat surgery if prolapse returns, usually due to:

Very weak tissues
Not following post-op instructions

Surgeons aim to reduce this risk using modern techniques and durable mesh.

19. Does bladder lift surgery prevent future pregnancy?

No, the surgery itself doesn’t prevent pregnancy, but a new pregnancy could put pressure on the bladder and affect the surgical result.
If you’re planning to conceive:

Talk to your doctor first
Ensure proper monitoring during and after pregnancy

20. What are the most important tips after bladder lift surgery?

To ensure a successful recovery, follow these key tips:

Complete rest for the first 2 weeks
Avoid heavy lifting
Abstain from sexual activity until your doctor approves
Stick to all follow-up appointments
Once healed, start Kegel exercises regularly to maintain the surgical result

When Does a Doctor Decide to Perform a Bladder Lift Surgery?

Bladder lift surgery is usually recommended when the bladder is no longer in its proper position due to weakened pelvic muscles or bladder prolapse. Here are the most common reasons a doctor might suggest this procedure:

1. Bladder Prolapse (Cystocele):

This occurs when the bladder drops from its normal position in the pelvis and pushes against the vaginal wall. You might feel:

A sensation of pressure or heaviness in the vaginal area
Frequent urination
Urine leakage
Pain or discomfort

2. Stress Urinary Incontinence:

This is when urine leaks involuntarily during physical activities like laughing, coughing, or lifting, due to weak pelvic support.

3. Difficulty Urinating or Urinary Retention:

When the bladder is out of place, it can be difficult to empty it fully or urinate comfortably.

4. Failure of Non-Surgical Treatments:

If pelvic floor exercises like Kegels or supportive devices (like vaginal pessaries) don’t help relieve symptoms.

5. Recurring Urinary Tract Infections:

Infections caused by poor bladder emptying due to prolapse.

Ultimately, surgery is considered when the symptoms seriously affect your quality of life and conservative treatments are no longer effective.

What Factors Can Reduce the Success of a Bladder Lift Surgery?

While bladder lift surgery is generally successful, several factors can impact the outcome or lead to recurrence. These include:

1. Ongoing Pelvic Muscle Weakness:

If your muscles remain weak or continue to weaken over time, the bladder may prolapse again.

2. Being Overweight or Obese:

Excess weight puts pressure on the pelvic floor, affecting bladder stability.

3. Chronic Constipation:

Repeated straining during bowel movements weakens pelvic muscles.

4. Chronic Coughing:

Common in smokers or those with lung conditions; it increases pressure on the pelvic area.

5. Multiple Pregnancies and Vaginal Deliveries:

These stretch and weaken the pelvic floor, increasing the risk of prolapse recurrence.

6. Not Following Post-Surgery Instructions:

Engaging in heavy lifting or intense activity too soon, or skipping pelvic floor exercises, can lead to failure.

7. Surgical Technique or Type of Procedure:

Some surgical approaches may not be ideal for every case or may have a higher complication rate.

8. Advanced Age:

With aging, tissues and muscles lose strength and elasticity, affecting long-term results.

9. Chronic Health Conditions:

Such as diabetes or poor circulation, which can interfere with healing.

10. Chronic Infections:

Ongoing urinary or vaginal infections can weaken tissue and delay recovery.

11. Certain Medications:

Drugs that slow healing or affect bladder function can play a role.

12. Nerve Issues:

Nerve damage (from spinal injuries or neurological diseases) can impair bladder and pelvic function.

13. Previous Pelvic Surgeries:

Scar tissue or anatomical changes from earlier surgeries can make it harder to achieve lasting results.

14. Incorrect Diagnosis:

If other conditions like uterine or rectal prolapse aren't treated along with the bladder issue, the surgery may not be fully effective.By addressing these factors with your doctor, you can increase the chances of a successful and lasting outcome from bladder lift surgery.

Types of Bladder Prolapse and Its Symptoms

Bladder prolapse, also known as cystocele or anterior vaginal wall prolapse, varies in severity and type depending on the condition. Here’s a clear and simple breakdown of the different types:

1. Types of Bladder Prolapse Based on Degree of Descent (Most Common in Diagnosis):

Grade 1 (Mild Prolapse):
The bladder descends slightly into the vagina but does not reach near the vaginal opening. Most of the time, there are no clear symptoms or problems.
Grade 2 (Moderate Prolapse):
The bladder descends to the level of the vaginal opening or just touches it. You may start to feel heaviness or pressure in the pelvic area.
Grade 3 (Severe Prolapse):
The bladder is visible at the vaginal opening or partially protrudes outside. This causes bothersome symptoms such as urine leakage and difficulty urinating.
Grade 4 (Complete Prolapse):
The bladder completely protrudes outside the vaginal opening. Often, other pelvic organs like the uterus or rectum also prolapse.

2. Types of Bladder Prolapse Based on Location of Descent:

Anterior Prolapse (Cystocele):
The most common type, caused by weakness in the front vaginal wall, allowing the bladder to push into the vagina creating a bulge.
Upper Posterior Prolapse Involving the Urethra (Urethrocystocele):
In this type, both the bladder and the urethra descend together, which may cause problems controlling urine or sudden leakage.

Associated Prolapses That May Occur Alongside Bladder Prolapse:

Uterine prolapse
Rectocele (rectal prolapse into the vagina)
Enterocele (small intestine prolapse into the vaginal space)

It is common to have prolapse of multiple pelvic organs simultaneously.

Risks and Side Effects of Bladder Lift Surgery

Although bladder lift surgery is very helpful, it’s important to be aware of potential risks to make an informed decision:

Infection:
Can occur at the surgical site or urinary tract, usually treated effectively with antibiotics.
Bleeding:
May happen during or after surgery; occasionally requires blood transfusion, but this is rare.
Postoperative Pain:
Pain is normal initially and usually decreases over time with pain medication.
Injury to Nearby Organs:
Rarely, the bladder, intestines, or blood vessels may be injured during surgery.
Urinary Incontinence or Voiding Problems:
Some women may experience new urine leakage or difficulty urinating after the operation.
Fluid Collections or Bruising:
Swelling or bruises around the surgical area are common and typically resolve over time.
Abdominal Adhesions:
Internal scar tissue may form, causing long-term pain or digestive issues.
Complications from Surgical Mesh (if used):
Can lead to inflammation, chronic pain, or tissue erosion.
Recurrence of Bladder Prolapse:
In some cases, the prolapse can come back over time.
Effects on Sexual Function:
Pain during intercourse or temporary changes in sensation may occur.

Harms of Bladder Prolapse

Bladder prolapse not only affects comfort but can also cause health and psychological problems. The main issues include:

Urinary Incontinence
Involuntary urine leakage occurs during activities like laughing, coughing, or lifting heavy objects, making daily life more difficult.
Difficulty Urinating
You may feel that the urine stream stops or that the bladder cannot be fully emptied, which can cause pain.
Recurrent Urinary Tract Infections (UTIs)
Residual urine in the bladder increases the risk of infections, leading to repeated UTIs.
Pelvic Pain and Pressure
A feeling of heaviness or pressure in the pelvic area, especially after standing or walking for long periods.
Visible Bulge at the Vaginal Opening
In some cases, part of the bladder may protrude as a noticeable lump, causing discomfort or embarrassment.
Pain During Sexual Intercourse
Many women report pain or discomfort during sex due to the prolapse.
Psychological Impact and Anxiety
These symptoms can lead to stress and anxiety, especially if there is urine leakage or visible bulging.
Bowel Problems (in Severe Cases)
Constipation or difficulty with bowel movements may occur due to bladder pressure on the rectum.
Decreased Quality of Life
These symptoms can make it hard to exercise, do daily activities, or even sit for long periods.

Stages of Bladder Lift Surgery

If you want to know the steps involved in bladder lift surgery, here is a simple and clear explanation from preparation to recovery:

1. Preoperative Preparation

A gynecologist or urologist will conduct a thorough exam to assess bladder condition.
Ultrasound or urine tests may be requested to evaluate the degree of prolapse.
You will discuss with your doctor the most suitable surgery type—traditional, laparoscopic, or robotic.
Blood thinners or certain medications may need to be stopped before surgery as per the doctor’s advice.
Fasting for 6 to 8 hours before the surgery day is required.

2. Anesthesia

General anesthesia is usually given, so you sleep throughout the operation.
In some cases, spinal anesthesia (regional) is used, where you stay awake but the lower body is numb.

3. Bladder Lift Surgery

The surgeon lifts the bladder and restores it to its normal position.
In cases of severe tissue weakness, a supportive mesh or tissue graft from your body may be used.
Surgery can be done through the vagina (most common) or through the abdomen, either by open surgery or laparoscopy.

4. Postoperative Care (Recovery Room)

Vital signs and health status are closely monitored.
A temporary urinary catheter is placed to help drain the bladder for the first couple of days.
Painkillers and antibiotics are given to manage pain and prevent infection.

5. Recovery Period

Hospital stay usually lasts 1 to 2 days depending on your condition.
Complete rest at home is recommended for 2 to 6 weeks depending on the surgery type.
Avoid lifting heavy objects and sexual intercourse during recovery.
Follow-up appointments 2 to 4 weeks after surgery are important to ensure proper healing.

Types of Bladder Lift Surgeries

If you suffer from bladder prolapse, it’s important to know there are several surgical options based on severity and your health needs. Here are the most common types explained simply:

Vaginal Surgery (Bladder Lift Through the Vagina)

The most common and relatively simple procedure.
The surgeon lifts the bladder through the vaginal opening without abdominal incisions.
Sutures or supportive mesh may be used to fix the bladder.
Advantages: Less invasive, faster recovery.
Disadvantages: Not always suitable for severe prolapse or recurrent cases.

Abdominal Surgery (Open Abdominal Surgery)

An incision is made in the abdomen to fix the bladder.
Used for complex cases, especially if multiple organs like uterus or rectum are prolapsed.
Advantages: Strong support, suitable for difficult cases.
Disadvantages: Longer recovery, more invasive.

Laparoscopic Surgery

Minimally invasive surgery done through small abdominal incisions.
Uses a camera and fine instruments to lift and secure the bladder.
Advantages: Small scars, less pain, faster recovery.
Disadvantages: Requires skilled surgeon and specialized centers.

Robotic Surgery

An advanced form of laparoscopic surgery where the surgeon controls a precise robotic system.
Offers greater accuracy, less bleeding, and faster healing.
Advantages: High precision, quicker recovery, less pain.
Disadvantages: Expensive and not available everywhere.

Use of Surgical Mesh

A synthetic mesh strengthens the bladder and surrounding tissues.
Can be used in vaginal, abdominal, or laparoscopic surgeries.
Disadvantages: Possible complications like inflammation, chronic pain, or tissue erosion; used cautiously.

Urethral Sling Procedure

Specifically for women with urinary incontinence along with bladder prolapse.
A supportive sling is placed under the urethra to prevent urine leakage.
The sling may be synthetic or made from the patient’s own tissue.

Burch Colposuspension

Surgery that attaches the vaginal wall supporting the bladder to the pubic bone.
Done through open or laparoscopic abdominal surgery.
Purpose: To lift and stabilize the bladder.

Sacrocolpopexy

Used for severe prolapse involving bladder and uterus.
Attaches the bladder and vagina to the sacrum (tailbone) using a surgical mesh.
Can be performed laparoscopically or robotically.

Native Tissue Repair (Non-Mesh Repair)

Uses the patient’s own tissues without synthetic materials.
Suitable for patients allergic to mesh or preferring natural repair.

Combined Repair Surgery

For prolapse involving multiple organs (e.g., bladder, uterus, rectum) repaired in one operation.
Reduces need for multiple surgeries and improves recovery time.

Symptoms to Contact Your Doctor Immediately After Bladder Lift Surgery

After the surgery, it’s very important to closely monitor your body. If you experience any of the following symptoms, you should contact your doctor immediately to avoid complications:

Heavy or continuous vaginal bleeding, especially if it doesn’t decrease or gets worse over time.
Severe pain in the surgical area that doesn’t improve with regular painkillers.
Significant swelling or redness around the surgical wound or vagina.
High fever over 38°C (100.4°F), which could indicate an infection.
Difficulty or severe pain when urinating, or inability to urinate completely.
Sudden urinary incontinence or unexpected urine leakage after the surgery.
Abnormal vaginal discharge that is green, yellow, or has a bad odor.
Swelling or pain in the legs, or changes in skin color (could be a sign of a blood clot).
Dizziness, fainting, or sudden general weakness.
Any signs of infection or inflammation at the wound site such as increased bleeding, unusual discharge, or excessive pain.

Top 16 Exercises to Strengthen and Lift the Bladder and Pelvic Muscles Easily at Home

Traditional Kegel Exercise
How to do it: Squeeze your pelvic muscles as if stopping urine flow, hold for 5 seconds, then relax.
Reps: 10 times, 3 times a day.
Fast Kegel Exercise
Description: Quickly squeeze and release pelvic muscles repeatedly.
Benefit: Good for stress urinary incontinence (leakage when laughing, sneezing).
Reps: 15 times, twice a day.
Pelvic Bridge Exercise
Position: Lie on your back, knees bent, lift your hips up, hold 5 seconds, then lower.
Benefit: Strengthens pelvic and glute muscles.
Reps: 10 times, twice daily.
Squats
Description: Stand with feet shoulder-width apart, lower as if sitting on a chair, then rise.
Benefit: Strengthens pelvic and leg muscles.
Reps: 10 times daily.
Lower Abdominal Lift
Position: Lie on your back, raise one leg without moving your hips, lower, then switch legs.
Benefit: Strengthens lower abs and pelvis.
Reps: 10 times per leg.
Cat-Cow Stretch
Description: On all fours, arch your back up like a cat, then lower it down like a cow.
Benefit: Relieves pressure and strengthens the pelvis.
Reps: 10 times, twice daily.
Side Leg Raise
Position: Lie on your side, slowly lift the top leg, then lower it.
Benefit: Strengthens thigh and pelvic muscles.
Reps: 10 times each side.
Pelvic Plank
Description: Rest on your elbows and knees or feet, keep your body straight.
Duration: Start with 10 seconds, increase gradually.
Benefit: Strengthens core and pelvic muscles.
Heel Slide Bridge
Position: Lie on your back, knees bent, lift hips, slide heel forward then back, switch legs.
Reps: 10 times.
Butterfly Stretch
Description: Sit with soles of feet together, gently spread knees apart.
Duration: 30 seconds, twice daily.
Benefit: Opens the pelvis and reduces tension.
Ball Squeeze Bridge
Position: Lie on your back, place a small ball between knees, squeeze it and lift hips, hold.
Reps: 10 times.
Pelvic Tilt
Position: Lie on your back, knees bent, press your lower back into the floor as if pulling pelvis in, hold 5 seconds.
Reps: 10 times.
Stability Ball Sitting
Description: Sit on an exercise ball, keep back straight, gently rock your hips side to side.
Duration: 5 minutes.
Benefit: Activates pelvic muscles and improves balance.
Hip Flexor Stretch
Position: Take a lunge stance, push hips forward with a straight back.
Duration: 20 seconds per leg.
Benefit: Reduces hip muscle tension that pulls on the pelvis.
Chair Sit and Stand
Description: Sit on a chair, stand up and sit down without using your hands.
Reps: 10 times.
Benefit: Strengthens legs and pelvic muscles.
Deep Breathing with Abdominal Contraction
Description: Take a deep breath, exhale while pulling your abdominal muscles inward as if “sucking in” your belly, hold.
Reps: 10 times.
Benefit: Strengthens deep muscles supporting the pelvis.