Women who are experiencing a lack of support from the tissues that hold their bladder in the proper position may be diagnosed with cystocele, also known as a prolapsed bladder. The bladder falls lower into the vagina and can cause urinary incontinence and discomfort. It can be caused by strain of the muscles around the pelvic organs during childbirth, chronic constipation, heavy lifting, or during the onset of menopause, as the body begins to go through the change with lowered estrogen levels.
Patients may have cystocele if they notice the following symptoms:
- Pressure in the pelvis or vaginal area.
- Discomfort during lifting, coughing, or bearing down on the pelvic region.
- Inability to empty the bladder completely.
- Recurrent bladder infections.
- Painful intercourse.
- Urinary incontinence.
- Bulge of tissues protruding from the vagina, improved by lying down.
Patients may be at a higher risk for cystocele if they have recently been pregnant, experienced vaginal childbirth, perform repeated heavy lifting, straining during bowel movements, and chronic severe coughing. Genetics, aging, and a previous hysterectomy may also play a part in increased risk for this condition.
Cystocele is diagnosed with a pelvic exam. Bladder tests may be completed to determine if the bladder is emptying properly and to look for any infections that may be present and require immediate treatment.
In cases of mild to moderate cystocele, a variety of non-surgical treatments can be done to strengthen the vaginal muscles and pelvic floor. Estrogen therapy and a pessary may be used to improve the condition with a non-surgical method. However, there are times in which surgery may be necessary to hold the bladder in place and improve functionality. Cystocele repair (also referred to as anterior repair) may be required when patients are experiencing chronic infections and pain with severe cystocele.
Patients considering surgery should be done having children as this can reverse any progress made when vaginal childbirth occurs. In the meantime, alternative therapies can be used and other options may be suggested to strengthen the pelvic floor and tighten muscles to reduce the problems associated with cystocele.