Cystocele, also known as prolapsed bladder, is the result of weakening and stretching of the wall between a woman's bladder and vagina, leading to the fall of the bladder into the vagina. This may also involve the uterus which descends into the vagina and protrudes from the vaginal opening.
The most common reasons for the occurrence of the disorder are pregnancy and childbirth. To facilitate intercourse and childbirth, the walls of the vagina have elasticity. In a case of vaginal childbirth, there is a likelihood of the walls getting stretched, leading to a prolapse. Also, women who have multiple children, have an increased chance of having this disorder. However, this might not be the only reason for the occurrence of cystocele disorder.
Sometimes, as women grow older or after their menopause, the decrease in the estrogen levels cause the degeneration of pelvic muscles, which in turn leads to cystocele. Cystocele can also be linked to obesity, chronic constipation, and even genetics. Having a hysterectomy or the removal of the uterus can also cause cystocele.
Symptoms of Cystocele
The symptoms of cystocele are displayed depending on the grade of the disorder. In case of a mild cystocele disorder or when the bladder drops only a short way into the vagina, there are no visible symptoms. For the higher grades of the disorder, that is, when the bladder falls far enough to reach the vaginal opening or when it actually comes through the opening of the vagina, the symptoms are severe.
Symptoms may include:
- Pressure in the pelvis and vagina, especially during extended periods of standing up.
- Difficulty in starting and stopping urination and increased urinary frequency
- Inability to empty the bladder after urination
- Difficulty while straining, coughing, and bending down
- Stress incontinence or loss of urinary control especially while laughing, sneezing, or coughing
- Recurring incidences of the urinary tract infection
- Extrusion of the tissue: With the increase in the severity of the case, the vagina and bladder may protrude outside the vaginal entrance
- Sexual Intercourse may result in pain and urinary leakage
Treatment of Cystocele
The treatment of the disorder is based on its severity. For mild cases without symptoms, the treatment may involve certain self care exercises and physiotherapy. In moderate cases, the use of a pessary is recommended. It is a device which when placed in the vagina holds the bladder in place. Based on the suitability and comfort, the doctor may recommend a pessary for the patient. Sometimes a tampon or diaphragm is also suggested as an alternative. Most of the time, this is a temporary solution for surgery.
In severe cases, surgery is recommended where the doctor places the bladder back to its normal position. The pelvic muscles are tightened and some parts of the stretched tissue may have to be removed. The operation is usually conducted by a gynecologist or an urologist.
Doctors also recommend the estrogen therapy for those who experience menopausal symptoms. This is done so as to keep the pelvic muscles strong that may have suffered degeneration due to the absence of estrogen after menopause. Sometimes, the doctors may recommend removal of the uterus if there is a prolapse of the uterus as well as the bladder. With the recurrence of cystocele, surgical treatment is recommended again.
Cystocele can be prevented by measures which include exercises, a high fiber diet, and drinking eight to ten glasses of water. For people with obesity, it is recommended that they consult the doctor to determine ideal weight.
Disclaimer: This article is for informative purposes only, and should not be treated as a substitute for professional medical advice.