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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11230
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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Hi, I'm 25 weeks pregnant with my first baby and for the last

Customer Question

Hi, I'm 25 weeks pregnant with my first baby and for the last 8 days have been suffering from bladder discomfort. I have a constant bladder sensation which ranges from a tickle to pain and feel the need to urinate frequently. Passing urine does not burn (it has a couple of times but generally not) but within about a minute the irritation starts up again. It is much more noticable when standing and walking than when sitting down.
My urine has been dipstick tested by both my 2 different GPs and my midwife and has come back completely clear. My GP has agreed to send it off to be 'cultured' (if that's how you express it?!) but says its unlikely anything will show.
I also asked both GPS to examine my pelvic floor as I've had mild stress incontinance since I was a teenager (I'm Now 33) and was worried that I might have some sort of prolapse. Both did quite a thorough examination lying down and asked me to cough a few times before telling me everything felt absolutely fine. However, since returning home I've done a bit of googling (dangerous I know) and saw a few women have written that there prolapse was only detectable in a standing position.
I decided to have a little feel and whereas when I am lying down the anterior vaginal wall feels quite 'spongy' to touch, when I stand up there is an organ-like firmness just above the bone at the bottom. With no medical knowledge whatsoever I am wondering if it is possible that when standing my bladder - or whatever that 'firmness' is - could be coming into contact with that bony structure? This 'firmness' is only when I press against the wall - there is no protusion of tissue into the vagina.
If this is not likely to be what is causing the irritation I wonder if you can tell me what the cause may be as after 6 days with no improvement I am worried that this is something I'm stuck with indefinitely and even walking very short distances is uncomfortable.
My GP seemed at a loss as to what the cause could be. She said that there was no evidence of thrush but that I could use a vaginal pessary just in case I had a low level infection without many symptoms. Is a vaginal pessary only a local treatment or could it possibly relieve my bladder symptoms.
Many thanks for any advice you may have.
Best wishes,
Anna
Ps. I have no history of any other bladder or gynecological problems
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. Norm S. replied 2 years ago.
Hello Anna and welcome.
I am Dr. Norm, and I look forward to helping you today.
It's hard to be very sure without doing an exam, but the bladder irritation and need to urinate frequently may be mostly due to pressure on your bladder from your baby.
You may also have some degree of prolapse, but there isn't very much that can be done about that other than to try to keep to much pressure off the pelvic area. There is a type of pessary made of plastic that the doctor can fit inside your vagina to help hold up your cervix, but with a growing pregnancy it usually doesn't do all that much good. Usually spending a lot of time lying down is best, ***** ***** you are more comfortable in that position.
In case there is a bladder infection, it may help a lot to treat that, sso it's good that your doctor did a culture.
I doubt that your symptoms have anything to do with thrush, or that thrush treatment will help your bladder symptoms.
What you feel down there which is spongy like while lying down and then gets firm when you stand up is likely the bladder area of your vagina. If it was your cervix protruding down, it would feel firm both lying and standing.
I'm sorry I don't have a better answer for you. For many discomforts during pregnancy, the most you can often do is to try to find comfortable positions. Best wishes.
Customer: replied 2 years ago.
Thank you that is very helpful - I can cope with the irritation as long as it's probably baby-related and worth it long term!
When I expressed my concern about prolapse it was actually bladder prolapse I was worried about as I'm pretty sure my cervix remains high in all positions at the moment. Is it quite normal to feel the bladder through the anterior wall in a standing position or does this suggest some degree of laxity/prolapse? Am I right in thinking a cystic else would've be likely to cause this irritation unless it was more severe?
Lastly, if the urine culture comes back negative do you think I should just put this down to being a pregnancy symptom, establish more of a keg elm routine and try to ignore it?
Many thanks for your advice - as you probably know, in the UK we don't see gynaecologists as a matter of course so are often in the dark about these things unless a major problem comes up.
Best wishes,
Anna
Expert:  Dr. Norm S. replied 2 years ago.
Yes, I think it's quite normal to feel the bladder through the anterior wall in a standing position. There is always some degree of laxity/prolapse during pregnancy, as things have a tendency to loosen up some due to hormones and pressure.
I'm afraid I don't understand this, "Am I right in thinking a cystic else would've be likely to cause this irritation unless it was more severe?"
If the urine culture comes back negative, I would put this down to being a pregancy symptoms, unless something further develops that would require further concern. I would do Kegels, although they may not make too much difference during the pregnancy.
Best wishes.
Customer: replied 2 years ago.
Haha sorry - auto correct on my phone! Was meant to say cystocele!!
Many thanks for your help.
Best wishes,
Anna
Expert:  Dr. Norm S. replied 2 years ago.
I don't think a cystocele is a main cause of your symptoms. A cystocele is a bulging out of the bladder, is pretty common, and you likely have some degree of cystocele.
You're very welcome, Anna. Best wishes to you.
Dr. Norm S. and other OB GYN Specialists are ready to help you
Expert:  Dr. Norm S. replied 2 years ago.
Thank you for your payment and rating.