Cystocele

Cystocele, also known as anterior prolapse (or a prolapsed bladder), happens when the supportive tissue between a woman's bladder and vaginal wall weakens and stretches, allowing the bladder to bulge into the vagina.

Cystocele can be caused by straining the muscles that support the pelvic organs — anything that weakens the supportive tissue between a woman's bladder and vaginal wall that causes the bladder to bulge into the vagina unnaturally.

This type of straining can occur during vaginal childbirth, chronic constipation, violent coughing or heavy lifting. The decrease in estrogen levels that happens during menopause can also be a contributor to forming a cystocele. A woman’s chance of developing a cystocele increases with age, possibly because aging tends to weaken the muscles and supportive tissues of the pelvic floor. Whether menopause increases a woman’s chances of developing a cystocele is unclear.

The symptoms of a cystocele may include:

• Vaginal bulge
• A sensation that something is falling out of the vagina
• The sensation of pelvic heaviness or fullness
• Difficulty with urination
• A feeling of incomplete urination
• Frequent or urgent urination
• Bladder leaks (urinary incontinence)

Women with mild cystoceles often do not have any symptoms.

Treatment for anterior prolapse depends on the grade of the cystocele. There are three grades of cystocele:

●      Grade 1: The mildest grade of cystocele, characterized by the bladder dropping only a little into the vagina

●      Grade 2: More moderate grade characterized by the bladder having dropped far enough into the vagina to reach the vaginal opening

●      Grade 3: Most advanced of all the stages, characterized by the bladder bulging out through the opening of the vagina.

 For a mild or moderate anterior prolapse (grade 1 or 2), nonsurgical treatment is often sufficient. In more severe cases (grade 3), surgery may be necessary to keep the vagina and other pelvic organs in their proper positions. Treatments for cystocele may include:

●      Avoiding certain activities that could cause the cystocele to worsen, such as heavy lifting or straining during bowel movements.

●      Regular, daily exercises of the pelvic floor muscles (Kegel exercises), may be recommended to make the pelvic floor muscles stronger.

●      Placement of a small, silicone medical device called a pessary into the vagina to hold the bladder in place.

●      Surgery may be necessary to relocate the bladder into its normal position.

●      Hormone replacement therapy may be suggested as a way to strengthen the muscles around the vagina and bladder.  If you are thinking about hormone replacement therapy, talk to your healthcare provider about the risks and benefits first.

If you are having trouble emptying your bladder or are experiencing heaviness or fullness of the bladder, contact your doctor. If you do have a cystocele, emptying your bladder can be difficult and can lead to bladder infections. If you are suffering from bladder or incontinence issues, Advanced Gynecology is here for you.

Our board-certified team of women’s health experts is ready to help you with diagnostic care and a range of treatment options including pain management and possible surgical options. We will counsel you about the best options for you and your health.