Cystocele, also known as prolapsed bladder, is a serious health issue. In a woman with this medical condition, the tough wall that lies between the bladder and vagina is not strong enough to support the bladder. As a consequence, the bladder falls into the vagina, causing various symptoms. Treatment is done by non-surgical as well as surgical techniques. Here, we will concentrate on the surgery, the actual procedure, and recovery.
If the doctor suspects cystocele, the complete medical history of the woman is examined along with the physical signs. Symptoms include problem in voiding the bladder, urinary incontinence, painful intercourse, pressure in the vagina, and at times, vaginal bulges. Women in their menopausal years and those who have been through repeated childbirths are at a higher risk of developing this bladder problem than others. For confirmation of bladder abnormalities, a void cystourethrogram is usually conducted.
Treatment by surgery is indicated if the patient experiences vaginal bulges and faces trouble in performing day-to-day activities. Do not confuse prolapsed uterus surgery with prolapsed bladder surgery. Both are conducted differently. However, if a patient is diagnosed with both conditions, the doctor may perform a single operation for addressing both the problems. According to the patient's preference and general health, surgery can be done by traditional open method or laparoscopy. Both methods take about 1 hour for completion.
Once in the hospital, the surgeon will run tests for vital signs before the actual procedure. A local or general anesthesia is given, followed by the surgery. The doctor accesses the affected wall through abdominal or vaginal incision. Surgery is aimed at placing the bladder back in its normal position. For loose muscles, fixing techniques include shortening and tightening them in pelvic floor. While in case of injured wall tissues, they are removed and the remaining healthy parts are sewn together to give a support structure to the bladder. After the surgery, antibiotics are administered to reduce bladder infections.
For most of the surgery patients, the hospital stay lasts for 2 - 3 days. Women who have had an open prolapsed bladder surgery require a longer stay than others who have done the minimally invasive laparoscopic technique. During this cystocele surgery recovery period, the doctor examines the dressings and urinary habit of the patient. Patients are allowed to go home after they can pass urine without any pain-related symptoms.
Complete rest and refraining from heavy lifting is expected during the recovery period. While stitches made at the incision site usually get dissolved within 8 - 12 days, complete recovery is achieved within six weeks. It is to be borne in mind that over straining of the muscles in pelvic floor and performing strenuous exercises increase the chances of recurrent bladder prolapse. If such is the case, repeated surgery would be required.
As with any type of surgery, the side effects and complications of this too do exist. Some of the risks factors include infection, pain at the incision site, and pain during intercourse. These are temporary conditions though, which will subside with correct postoperative care tips. In order to reduce them, maintain good bowel habit, avoid straining at any cost, and do not have intercourse for 1½ months. Severe complications are bleeding, blood clots, anesthesia effects, and injury to the bladder, urethra, and other internal parts.
In a nutshell, the results are very good. More than 70% of the patients get relief from uncontrolled leakage of urine and general cystocele symptoms. Follow the doctor's directions for performing mild pelvic exercises and other lifestyle changes, to prevent recurrence of cystocele.