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Cystocele

A cystocele occurs when the muscles and tissues that support the bladder weaken, allowing the bladder to bulge into the vagina. It is common in women who have given birth vaginally and with age. Symptoms include feeling a bulge in the vagina, urinary incontinence, frequency, and pressure. Treatment options range from pelvic floor exercises to pessaries to surgery depending on the severity of symptoms and degree of prolapse. Leaving a cystocele untreated can in rare cases lead to kidney problems over time.

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Milen De Leon
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413 views4 pages

Cystocele

A cystocele occurs when the muscles and tissues that support the bladder weaken, allowing the bladder to bulge into the vagina. It is common in women who have given birth vaginally and with age. Symptoms include feeling a bulge in the vagina, urinary incontinence, frequency, and pressure. Treatment options range from pelvic floor exercises to pessaries to surgery depending on the severity of symptoms and degree of prolapse. Leaving a cystocele untreated can in rare cases lead to kidney problems over time.

Uploaded by

Milen De Leon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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CYSTOCELE  

               

  Normal Pelvis                                  Pelvis with a cystocele

In normal conditions in women, the bladder is held in place by a "hammock" of


supportive pelvic floor muscles and tissue. When these tissues are stretched
and/or turn out to be frail, the bladder can drop and bulge through this layer and
into the vagina which results in bladder prolapse that is also called cystocele.

A cystocele – also identified as a prolapsed, herniated, dropped or fallen


bladder, is a downward displacement of the bladder toward the vaginal orifice. It
is a bulging or outpouching of the bladder in the anterior vaginal wall caused by
the thickening of the pelvic musculature. As a result, the bladder, covered by the
vaginal mucosa, prolapses into the vagina. The disorder typically appears some
years later when genital atrophy associated with aging happens, but younger,
multiparous, premenopausal women may also be affected. To reveal this, while
the labia are gently separated to allow a view of the vaginal walls, a woman is
asked to bear down as if she were moving her bowels.

Etiology

A cystocele commonly occurs when the muscles and supportive tissues among
a woman’s bladder and vagina weaken and stretch, that lets the bladder sag
from its normal position and bulge into the vagina or through the vaginal
opening. In this disorder, the bladder tissue remains covered by the vaginal skin.
This may result from damage to the muscles and tissues that hold the pelvic
organs up inside the pelvis. Damage to or weakening of the muscles and
supportive tissues may arise after vaginal delivery and with circumstances that
repeatedly increase pressure in the pelvic area, for example repetitive straining
for bowel movements, constipation, chronic or violent coughing, heavy lifting, 
being overweight or obese.

Chances of developing of this problem may be through increase of age, probably


due to weakening muscles and supportive tissues from aging. It is still unclear
whether menopause has a high chance of developing a cystocele in a woman.

Symptoms

Feeling of something bulging through the vaginal opening


Urinary problems such as incontinence, frequency and urgency
Frequent urinary tract infection
Pelvic pressure. This feeling may worsen when the person with
cystocele is standing, lifting, coughing, or as the day goes on.
Painful sex
Fatigue
Back pain and pelvic pain

Women who have a cystocele may also leak some urine as an effect of
movements that put pressure on the bladder, termed stress urinary incontinence.
These actions include coughing, sneezing, laughing, or physical activity, such as
walking. 

Urinary retention may occur with more severe cystoceles if the cystocele makes
a kink in the female’s urethra and blocks urine flow.
Note: Women with mild cystoceles often do not have any symptoms.

Treatment/ Management

The treatment of person with cystocele depends on the severity of the problem
and whether a woman has symptoms. If a woman’s cystocele does not cause
any inconvenience to her, a health care provider may recommend only that she
avoid heavy lifting or straining, that could worsen her cystocele. You do not need
to treat your pelvic organ prolapse if it is not causing you difficulties and is not
blocking your urine flow.

If a woman has signs and symptoms that troubles her and wants treatment, the
health care provider may recommend pelvic muscle exercises, a vaginal
pessary, or surgery. 

Kegel exercises are prescribed to help strengthen these weakened muscles. The
exercises are more effective in the early stages of a cystocele. These exercises
are easy to execute and are suggested for all women, including those with
strong pelvic floor muscles. This may be useful when the woman is experiencing
urinary stress incontinence. 

A pessary is a small, silicone device inserted in the vagina that supports the
vaginal wall and holds the bladder in place. This device comes in different sizes
and shapes. In some cases, surgery to repair such conditions may be
necessary.

Cystocele repair may be done to move the bladder back into normal position.
Hormone replacement therapy- helps to strengthen the muscles around the
vagina and bladder.

If prolapse is left uncured, through time it may stay the same or slowly gets
worse. In uncommon cases, severe prolapse can cause obstruction of the
kidneys or urinary retention which may lead to kidney damage or infection.

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