Table of Contents
Definition of Cystocele
Cystocele is more common after MENOPAUSE and in women who have given birth vaginally.
It occurs as a consequence of weakened vaginal and pelvic muscles and ligaments that allow the supportive structures for the bladder to relax and the bladder itself to drop.
Doctors believe the prime culprit is the intense straining that occurs during vaginal birth, which weakens muscles, coupled with changes in the elasticity of MUSCLE tissue that take place when levels of ESTROGENS drop in a woman’s body with menopause.
Symptoms and Diagnosis
The symptoms of cystocele may include the sensation of vaginal pressure, difficulty urinating, or URINARY RETENTION. Chronic URINARY TRACT INFECTION (UTI) may also occur, especially when the extent of the cystocele is such that residual URINE remains in the bladder after URINATION. The doctor can usually diagnose cystocele via vaginal palpation during a PELVIC EXAMINATION, as the sagging bladder causes the vaginal wall to bulge inward. When the diagnosis or the extent of the cystocele is uncertain the doctor may conduct a voiding CYSTOURETHROGRAM to determine whether the bladder fully empties with urination.
Treatment, Repair and Surgery
Mild cystocele that causes no symptoms may require only watchful waiting. The urologist or gynecologist may also recommend a pessary, a device placed within the vagina that gives added support to the vaginal wall.
Surgical repair is the treatment of choice for cystocele that interferes with urination, particularly when such interference causes chronic UTI. The surgery tightens the ligaments and muscles of the pelvic floor, restoring support for the bladder. Open surgery requires six to eight weeks for full recovery. Often the surgeon can do the repair laparoscopically, reducing recovery time to two to three weeks.