In women, the bladder and the vaginal wall are connected with the help of a supportive tissue. Certain factors cause this tissue to become weak to such an extent that it stretches and causes the bladder to bulge into the vagina. And when this happens, the medical condition is named as cystocele or 'fallen bladder'. As the bladder droops into the vagina, it starts causing a variety of unpleasant symptoms.
This condition is staged in three types depending upon its severity. In stage 1, the bladder falls only a short way into the vagina, and in stage 2, the bladder manages to reach to the opening of the vagina. And in stage 3, which is the most severe, the bladder can be visible at the opening of the vagina. Non-surgical treatment methods are good enough for mild to moderate cases of this condition, however, for the severe form, such as stage 3, a surgical procedure may be necessary. And this is known as a cystocele repair.
What is Cystocele Repair?
As explained above, it refers to the surgery that in undertaken to deal with the severe form of this cystocele, which is characterized by noticeable, and uncomfortable symptoms. The surgery is performed under a general anesthetic. However, some cases may require spinal or epidural anesthesia. Also, the procedure may be taken up by a gynecologist, a urologist, or a urogynecologist.
The surgeon makes an incision in the vaginal wall, and the bladder is separated from the vagina. Also, the muscles and ligaments of the pelvic floor are repaired and tightened, and the surgeon elevates the fallen bladder back in its place. The excess vaginal tissue is removed. Buttressing sutures are used to support the bladder, and the incision is stitched. For some people, the cystocele repair has to be undertaken more than once if the condition recurs.
Now, if the condition is causing few or no obvious symptoms, then this surgery may be ruled out. For mild cases, patients may be recommended the use of vaginal pessary. This device is a ring (made of rubber or plastic), that has to be inserted in the vagina. Doing this would help push the bladder get back into its place. Some people may benefit from estrogen therapy in the form of a cream, a pill or a ring to be used in the vagina,. These estrogen-based products help in keeping the pelvic muscles strong. Now we shall see some information on the causes and symptoms of the bladder muscle drooping into the vagina.
Causes and Symptoms of Cystocele
Causes include obesity, repeated activities, which include heavy lifting, straining while bowel movements, menopause, and a long-lasting cough.
Common symptoms are as follows:
- The patient might have a feeling of fullness in the pelvis and vaginal area.
- A feeling of incomplete evacuation after urination.
- The occurrence of something bulging out of the vagina.
- Incontinence (triggered by coughing, laughing, sneezing, etc).
- Urinary leakage during sexual intercourse.
- Bladder infections (recurring).
Post a cystocele repair, the patient might have to stay at the hospital for several days. It may take 4-6 weeks before the patient can have a complete recovery. Performing Kegel exercises under the guidance of a therapist, helps in strengthening the pelvic floor muscles thus, preventing and treating some of the symptoms of cystocele.