Pelvic organ prolapse (POP) is a prevalent medical condition that predominantly affects women, occurring when the pelvic organs undergo descent from their usual anatomical positions. These organs, including the bladder, uterus, and rectum, are normally supported by a complex network of muscles, ligaments, and connective tissues within the pelvis. However, factors such as childbirth, aging, obesity, chronic coughing, and pelvic surgery can weaken or damage these supportive structures, leading to pelvic organ prolapse.

During pelvic organ prolapse, the weakened pelvic floor muscles and connective tissues are unable to adequately support the weight of the pelvic organs, causing them to sag or bulge downward into the vaginal canal or even protrude outside the body through the vaginal opening. This descent can vary in severity, ranging from a mild condition that may not cause noticeable symptoms to a more severe form where the organs visibly protrude from the body.

The symptoms of pelvic organ prolapse can vary widely among individuals and depend on several factors, including the severity of the prolapse and which organs are affected. Common symptoms may include a sensation of pressure or fullness in the pelvic region, discomfort or pain during sexual intercourse, urinary problems such as incontinence or difficulty emptying the bladder completely, bowel issues like constipation or difficulty with bowel movements, and visible bulging or protrusion in the vaginal area, particularly during activities such as standing, coughing, or lifting heavy objects. 

What is Cystocele?

Cystocele, also referred to as an anterior prolapse or a prolapsed bladder, is a type of pelvic organ prolapse (POP) that occurs when the supportive tissues between the bladder and the vaginal wall weaken or stretch, allowing the bladder to protrude into the vaginal space. 

When a cystocele occurs, the bladder may descend downward into the vagina, creating a bulge or lump that can be felt or seen. This bulge can vary in size and severity, ranging from a small, mild protrusion to a more noticeable and uncomfortable descent. The degree of prolapse can also impact the severity of symptoms experienced by the individual. 

Symptoms of Bladder Prolapse

Symptoms of a cystocele can manifest differently among individuals and may include sensations of pressure or fullness in the pelvic region, discomfort or pain during activities such as standing, walking, or lifting, urinary symptoms like frequent urination, urgency, or difficulty emptying the bladder completely, and stress urinary incontinence, where urine leakage occurs during exertion or increased abdominal pressure.

How to Treat and Manage Cystocele

Managing a cystocele typically involves a combination of conservative treatments and, in some cases, surgical intervention. Conservative treatment options may include pelvic floor exercises, also known as Kegel exercises, which aim to strengthen the muscles supporting the bladder and improve pelvic floor support. Lifestyle modifications, such as maintaining a healthy weight and avoiding activities that strain the pelvic floor muscles, can also be beneficial. Additionally, the use of pessaries, which are supportive devices inserted into the vagina to help hold the bladder in place and alleviate symptoms, may be recommended. Lastly, bladder prolapse support underwear can be helpful in providing support to the prolapsed bladder and eliminating symptoms of pain and urinary leakage.

In cases where conservative measures are ineffective or symptoms are severe, surgical intervention may be necessary. Surgical procedures for cystocele repair aim to restore proper bladder support and reinforce the weakened pelvic floor tissues. These procedures can often provide significant relief from symptoms and improve quality of life for individuals with a cystocele.

FemiCushion: Support Underwear for Bladder Prolapse

For women who are waiting for surgery or do not wish to undergo surgery, FemiCushion is an alternative treatment option. It is a specialized device designed to provide support and comfort for individuals experiencing all types of pelvic organ prolapse (POP). This type of prolapse support undergarment is most suitable for stages 1-3 of prolapse. The non-invasive nature of this product gives user complete control over their treatment option making it convenient and easy to use. 

How to use FemiCushion

Proper usage of FemiCushion is essential to ensure its effectiveness in alleviating symptoms and improving pelvic floor support. Below are general guidelines on how to use FemiCushion:

1. Selecting the Right Size: FemiCushion comes in different sizes to accommodate varying degrees of pelvic organ prolapse and individual anatomical differences. It's essential to choose the appropriate size of FemiCushion supporter size based on your waist measurement.
2. Cleaning and Preparation: Before using FemiCushion for the first time, thoroughly wash and sanitize the cushions and support pads according to the manufacturer's instructions. Ensure that all components are clean and dry before use to maintain proper hygiene.
3. Putting on the Device: Insert the silicon cushion properly into the cloth holder as directed in the instruction manual. Return all prolapsed organs into the body before putting on the device. Position the cushion over the vaginal opening and put on the prolapse support underwear. Then make adjustment on the vertical and horizontal belts according to your body shape and the degree of support needed. When worn properly, the device will provide support to the prolapsed organs and relieve pressure on the pelvic floor muscles.
4. Wearing FemiCushion: Wear FemiCushion as directed by your healthcare provider or according to the manufacturer's instructions. The device is designed to be discreet and comfortable. Ensure that FemiCushion fits snugly and securely against your body to maximize its effectiveness.
5. Adjustment and Comfort: As you wear FemiCushion, you may need to make minor adjustments to ensure optimal comfort and support. Pay attention to any discomfort or pressure points and adjust prolapse supporter as needed.
6. Maintenance: FemiCushion is only worn during the daytime and taken off at night when sleeping. At the end of each day take of the device and clean each components according to the instructions provided to be ready for the next day use. 

FemiCushion Research Study

A study carried out at Showa University Northern Yokohama Hospital and detailed in The Journal of Obstetrics and Gynecology Research examined the effectiveness of FemiCushion in addressing pelvic organ prolapse (POP) through the use of magnetic resonance imaging (MRI). The study involved twelve participants aged between 56 and 84 years old, all presenting severe stages 3 or 4 of POP.

The key discoveries from the research are:

• FemiCushion demonstrated notable success in repositioning prolapsed pelvic organs.
• The device achieved outcomes comparable to those of a pessary, yet without the associated risks such as vaginal erosion and bleeding.
• FemiCushion not only raised the prolapsed organs but also provided support to the perineal body in an upward direction while closing the hiatuses.
• Individuals with severe POP experienced a significant decrease in prolapse severity following FemiCushion use.
• Even with a brief usage period, as little as one month, FemiCushion exhibited enhancements in POP. 

These findings underscore the potential of FemiCushion as a non-invasive treatment avenue for POP, delivering advantages akin to a pessary while diminishing certain risks. The outcomes of the study suggest promising strides in the management of pelvic organ prolapse, particularly for those with severe stages of the condition. 

Using FemiCushion as directed and in conjunction with other treatment methods like Kegel exercises can help alleviate symptoms of pelvic organ prolapse and improve pelvic floor support. If you have any questions or concerns about using FemiCushion, be sure to consult with your healthcare provider for guidance and support.

Pelvic organ prolapse is a challenging condition that can significantly impact a woman's quality of life. However, with proper diagnosis and appropriate management, individuals with pelvic organ prolapse can often find relief from their symptoms and regain control over their pelvic health. It's important for individuals experiencing symptoms of pelvic organ prolapse to seek medical evaluation and treatment from a qualified healthcare provider to ensure the most effective and personalized care.

Supervising Doctor of This Article

Koichi Nagao, MD PhD

Professor, Department of Urology, Toho University Faculty of Medicine
Director of Urinary tract reconstruction center, Toho University Omori Medical Center
Director of Reproduction Center, Toho University Omori Medical Center

Professor Nagao specializes in plastic surgery in the field of reproductive medicine. He completed eight years of plastic surgery training at Showa University before majoring in urology at Toho University. With his meticulous surgical techniques and careful examinations that combines urology and plastic surgery, Professor Nagao became a Board Certified Specialist with multiple associations including the Japanese Urological Association, the Japan Society for Reproductive Medicine, and the Japanese Society for Sexual Medicine.