The bladder is held up by a structure and framework of muscles and ligaments that make up the pelvic floor. Due to certain factors, this strong network of muscles becomes weak, causing the wall between the vagina and the bladder to drop and result in a cystocele.
Put simply, a cystocele is a type of hernia in which the urinary bladder protrudes, falls or prolapses and thereby pushes through the wall of the vagina. This condition occurs only in women. Cystoceles are quite bothersome and unless they are very mild, will present with a variety of symptoms. Listed below are some of the common symptoms that may be experienced with a cystocele.
Urination And Associated Infections
Patients often complain of a variety of symptoms that are associated with micturition (urination). Frequency to urinate because of the pressure on the uterus is one such symptom. The patient may also get a very unsatisfactory feeling of not having completely emptied the bladder after passing urine. The urgency or the need to urinate but unable to do so when one tries, is another feeling that is very often associated with a cystocele.
The patient may also have difficulty controlling her bladder and may have a ‘leak’. With a woman being susceptible to such a wide variety of urinary problems, it is not surprising that urinary tract infections (UTIs) are commonly experienced when suffering from a cystocele. The intensity of the infection will vary and should be treated as soon as it is detected.
Pain And Discomfort
The bladder and the vagina are in close proximity with each other and therefore pain and discomfort may be experienced in either the bladder or vagina. Sometimes a general feeling of discomfort or a dull throbbing pain may be experienced in the lower abdomen. If there is infection, pain in the lower back may be experienced. Pain may also be experienced during intercourse.
A feeling of heaviness may be experienced if the prolapse is very predominant. The patient may experience a feeling of heaviness in the pelvic region. The is a feeling like the lower abdomen being weighed down and in severe cases the pressure is so intense that it may seem like the insides are going to pop out of the body.
Treatment of a cystocele will depend on the intensity of the condition. A cystocele that is very mild in nature may be left alone, while one that is predominantly prolapsed may require treatment.
One of the most simple and effective treatments – especially if the prolapse is very mild, is Kegel exercises. This is a set of pelvic floor exercises that strengthens the muscles of the pelvic floor and prevents further prolapse of the bladder. The exercises are a set of contractions and relaxations of the muscles of the pelvic floor.
The patient is asked to contract the muscles as she would do if she were controlling a full bladder, relax the muscles as she would do when in a state of complete relaxation.
If the prolapse is very severe, a small device is inserted into the vagina. This device aides in the upliftment of the bladder and prevents it from drooping. In other words, the pessary holds the uterus up in the right position. These vaginal pessaries are made from either rubber, plastic or silicon. The patient may need to try a few pessaries before she finds one that will make her feel comfortable.
Surgery is the final alternative and is opted for when all else fails. This is the last option and is the preferred mode of treatment when the prolapse is very severe and cannot be relieved with other treatment options such as HRT (hormone replacement therapy) and pessaries. The prognosis of cystocele surgeries is very good, and with this surgery, one can expect complete recovery.
Estrogen replacement therapy is another form of treatment when the prolapse is due to menopause. Estrogen therapy strengthens the slack muscles and relieves the prolapse. Estrogen is known to tighten the muscles and either reduce the prolapse or cure it completely – depending on the severity of the prolapse.