Cystocele

A cystocele, also known as a prolapsed bladder, occurs when the supportive tissue between a woman's bladder and vaginal wall weakens and stretches. This allows the bladder to bulge into the vagina.

Causes:

Several factors can contribute to the development of a cystocele, including:

• Childbirth: Vaginal delivery, especially multiple births or difficult deliveries, can weaken the pelvic floor muscles.
• Aging: As women age, the tissues and muscles that support the pelvic organs naturally lose elasticity and strength.
• Hysterectomy: Removal of the uterus can sometimes weaken the supporting structures of the pelvic floor.
• Chronic Coughing or Straining: Persistent coughing (e.g., from chronic bronchitis) or straining during bowel movements (e.g., due to constipation) can put extra pressure on the pelvic floor.
• Obesity: Excess weight can increase pressure on the pelvic organs.
• Heavy Lifting: Repeatedly lifting heavy objects can strain the pelvic floor muscles.
• Genetics: Some women may be genetically predisposed to developing a cystocele.

Symptoms:

The severity of symptoms varies depending on the degree of bladder prolapse. Some women with mild cystoceles may experience no symptoms. More severe cystoceles can cause:

• A feeling of pressure or fullness in the vagina.
• A bulge in the vagina that may be felt or seen.
• Difficulty emptying the bladder completely.
• Frequent urination or urgency.
• Urinary incontinence (leakage of urine).
• Recurrent bladder infections.
• Painful sexual intercourse.
• Pelvic pain.

Diagnosis:

A cystocele is typically diagnosed during a pelvic exam. The doctor may ask the woman to strain as if having a bowel movement to better visualize the prolapse. Additional tests, such as a cystoscopy (examination of the bladder with a camera) or urodynamic testing (to assess bladder function), may be performed.

Treatment:

Treatment options for cystocele depend on the severity of the prolapse and the symptoms it is causing. Options include:

• Observation: For mild cystoceles with minimal symptoms, observation may be sufficient.
• Pelvic Floor Exercises (Kegel Exercises): These exercises can strengthen the pelvic floor muscles and help support the bladder.
• Pessary: A pessary is a removable device inserted into the vagina to support the bladder and keep it in place.
• Surgery: Surgery may be necessary to repair a severe cystocele. Surgical options include vaginal repair (suturing the weakened tissues) or abdominal repair (using mesh to support the bladder).

Prevention:

While it's not always possible to prevent a cystocele, certain measures can reduce the risk:

• Performing regular Kegel exercises.
• Maintaining a healthy weight.
• Avoiding heavy lifting.
• Treating chronic cough or constipation.
• Using proper body mechanics when lifting.