A cystocele or prolapse of the bladder refers to the descent or fall of the bladder inside the vagina as a result of a significant weakening or stretching of the muscles of the pelvic region. In more severe cases, the bladder may begin to protrude out of the body through the opening of the vagina. This much more common condition in women who have had multiple or complicated and menopausal deliveries requires one treatment or another depending on the degree of severity it presents, because in moderate or severe cases a surgical intervention may be necessary for the bladder to return. to be placed in its original position; however, in some very mild cases, it may be enough to perform some exercises that strengthen pelvic sleep and prevent the prolapse from progressing.
In this FastlyHealarticle we talk in detail about cystocele or bladder prolapse: symptoms, grades and treatment.
Causes of cystocele
The fall of the bladder in the vaginal canal occurs as a consequence of a weakening or stretching of the pelvic floor, and it is that as time goes by the muscles and structures that support and maintain the uterus, bladder, the rectum and vagina can lose elasticity and lead to prolapse or sagging of some of these organs.
There are several factors that can cause bladder prolapse and a bulge in the vagina can be seen. Among the main causes of cystocele are the following:
- Pregnancy and childbirth: very long or complicated deliveries, babies with a lot of weight or having gone through multiple deliveries causes the pelvic floor muscles to be subjected to great tension and this can lead to their weakening and a subsequent lowering of the bladder .
- Overweight or obesity: women who are overweight or obese have a higher risk of suffering from cystocele, since their pelvic muscles bear greater tension.
- Aging: when the menopause stage is reached , the female body experiences a drop in estrogen levels and this, among other things, causes a weakening of the pelvic floor.
- Exertion: repeated heavy lifting, chronic cough or severe and prolonged constipation are factors that can also cause weakness of the pelvic muscles.
- Surgeries: Certain pelvic surgeries, such as hysterectomy, can increase the chances of having a bladder prolapse.
Symptoms of cystocele
It is important to note that in milder cases of cystocele, the patient may not notice any symptoms. However, when signs do occur, cystocele symptoms can include the following:
- Feeling of heaviness or pressure in the pelvic region and in the bladder. This discomfort is usually worse when standing, coughing, sneezing, laughing, running, gaining weight, etc.
- Feeling of not having completely emptied the bladder even after urinating.
- Urinary incontinence or involuntary loss of urine.
- Note the presence of a bulge in the genital area. In the most severe cases, it can protrude through the vaginal opening.
- Repetitive urine infections.
- Pain in the lumbar area.
- Difficulty defecating or constipation.
- Pain or discomfort during sexual intercourse.
- Discomfort when urinating
The symptoms of bladder prolapse will be more or less intense depending on the degree of cystocele that is present. According to the level of descent of the bladder, specialists have determined that it can be classified into:
- Grade I: mild prolapse, the bladder only descends slightly through the vaginal canal.
- Grade II: moderate prolapse, the descent of the bladder reaches the vaginal opening.
- Grade III: severe prolapse, the bladder bulges out through the vagina.
Given the suspicion of having a cystocele or the manifestation of the symptoms described above, it is essential to go to the doctor or gynecologist to undergo a physical examination and the appropriate tests in each case.
Diagnosis of cystocele
The diagnosis of a cystocele will consist of an initial study of the symptoms that the patient presents and a physical examination of the pelvic region to check if there is a bulge inside the vagina that indicates the condition of the prolapse. The affected person may be asked to contract the pelvic floor muscles to check their strength and whether or not there is leakage of urine.
Other medical tests that may be recommended to verify that it is a case of fallen bladder are the following:
- Urine analysis
- Blood test
- Bone scan
- Magnetic resonance
- Urodynamic test
Treatment of cystocele
The treatment of cystocele will vary in each case depending on the degree of prolapse that is present and the symptoms that are causing the condition.
In very mild cases, it may be enough to perform the so-called Kegel exercises, which serve to reinforce and strengthen the pelvic muscles and prevent the advance of the bladder descent.
To do them correctly, you must contract the pubcoccygeus muscle (as if you wanted to stop the flow of urine during urination) for about 5 seconds and then relax again for another 5 seconds. In the article Kegel exercises for uterine prolapse we explain it in more detail.
The specialist may recommend estrogen treatment in women who have already experienced menopause. Estrogen helps keep your pelvic floor strong and prevents bladder prolapse from getting worse. Administration can be orally through a pill, topically through a cream, or by inserting a ring into the vagina.
Placement of a pessary
In some patients, a plastic or rubber ring, called a pessary, may be placed inside the vagina in order to support the bladder and thus prevent its descent from further progressing.
Cystocele: surgical intervention
In moderate or severe cases, a cystocele operation may be necessary to return the bladder to its initial position. A kind of small meshes can be placed to support the bladder and prevent it from descending again.
The intervention usually has very good results, it is possible that general or regional anesthesia is used depending on each case. Its duration is quite short and does not usually require the patient to spend more than 24 hours in the hospital.
Cystocele surgery: recovery
After undergoing surgery for cystocele, it is important that the patient follow the following recommendations to enjoy a good recovery and avoid complications:
- Avoid lifting weights or objects that weigh more than 4.5 kg, especially during the 6 weeks following the intervention.
- Take rest.
- Do not insert items or products into the vagina, such as tampons, for the next 6 weeks.
- Avoid having sexual intercourse until about a month and a half after surgery.
- Drink plenty of water throughout the day and eat a healthy diet rich in fiber to prevent constipation.
This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.
If you want to read more articles similar to Cystocele or bladder prolapse: symptoms, degrees and treatment , we recommend that you enter our Kidneys and urinary system category .
I am a Surgeon with a diploma in comprehensive ultrasound and surgical care residency, an area I am specializing in. During the exercise of my profession, I have realized the need for patients to know the diseases they suffer, and I can tell you that a large part of their complications is due to a lack of information. Being a health web writer allows me to transmit my experience, without borders, to all those readers eager for knowledge, educate them in the prevention of diseases and promote a healthy lifestyle.