What is a cystocele?
Cystocele is the name for a hernia-like disorder in women that occurs
when the wall between the bladder and the vagina weakens, causing the
bladder to drop or sag into the vagina.
What are the results of a cystocele?
In addition to discomfort, the resulting dropped bladder can cause two
kinds of problems to occur, including the following:
- urine leakage
- incomplete emptying of the bladder
The dropped bladder stretches the opening into the urethra, and urine
may leak when a woman does any action that causes pressure on the bladder,
such as coughing.
What are the grades of cystoceles?
| grade
1 |
mild - the bladder
droops only a short way into the vagina. |
| grade
2 |
more severe - the
bladder has sunk into the vagina far enough to reach the opening of
the vagina. |
| grade
3 |
most advanced - the
bladder bulges out through the opening of the vagina. |
What causes a cystocele?
A cystocele may result from the following:
- straining muscles during childbirth
- repeated straining during bowel movements
- menopause
The hormone estrogen helps keep the muscles around the vagina strong,
but, with menopause, the body stops making estrogen and the muscles
around the vagina and bladder may become weakened.
How is a cystocele diagnosed?
In addition to a complete medical history and physical examination (which
may reveal the fallen part of the bladder through the vagina), diagnostic
procedures for a cystocele may include a cystourethrogram (also called
a voiding cystogram). This is an x-ray of the bladder during urination
and with the bladder and urethra filled with contrast medium to determine
the shape of the bladder and any obstructions.
Other tests and procedures may be necessary to determine if there are
any problems in the other areas of the urinary system.
Treatment for cystoceles:
Specific treatment for cystoceles will be determined by your physician
based on:
- your age, overall health, and medical history
- extent of the disease
- your tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Treatment may include:
- activity modification (i.e., avoiding heavy lifting or straining that
could cause the cystocele to worsen)
- pessary - a device placed in the vagina to hold the bladder in place.
- surgery (to move the bladder back into a more normal position)
- estrogen replacement therapy (may help to strengthen the muscles around
the vagina and bladder)
If you are considering hormone replacement therapy, the decision to
start should be made only after you and your physician have evaluated
the risk versus benefit ratio based on your individual medical history.
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