Dropped Bladder Cystocele

By
Healthiack.com Editorial Team

Overview, Causes, & Risk Factors

Cystocele is a condition in which part of the bladder drops down, or protrudes,into the wall of the vagina.

What is going on in the body?

The bladder is the holding place for urine. It lies just above the vagina in afemale. Between the bladder and vagina is a wall made of tissues and musclesthat support the bladder and the urethra. The urethra is a tube that carriesurine from the bladder to the outside of the body.

When a woman has a cystocele, the wall supporting the bladder is weaker thanusual. This weakening allows part of the bladder to protrude or drop down intothe vagina. As the bladder droops into the vagina, the urethra becomesstretched, allowing urine to leak out of the urethra.

What are the causes and risks of the disease?

A cystocele results from a weakening or stretching of the tissues supporting thebladder. The causes of this weakening include:

  • muscles and tissues being stretched during childbirth
  • heavy lifting that causes stress on the muscles surrounding the vagina andbladder
  • repeated straining during bowel movements, which can be caused by frequentconstipation
  • menopause. Estrogen helps keepthemuscles around the bladder and vagina strong. During menopause, estrogen levelsdecrease.
  • normal aging, which can cause the muscles to become weaker

    • Symptoms & Signs

    What are the signs and symptoms of the disease?

    The 2 most common symptoms of cystocele are:

  • difficulty emptying the bladder during urination
  • stress incontinence, aconditionthat causes leakage of urine when pressure is put on the bladder by coughing,sneezing, or laughing

    • Other symptoms may include:

  • pelvic pain
  • abdominal distress
  • frequent urination
  • feeling an urgency to urinate
  • painful urination
  • feeling of a bulging in the vagina

    • Diagnosis & Tests

    How is the disease diagnosed?

    Diagnosis begins with a complete history and physical, including a pelvic exam. Other tests may include:

  • ultrasound, which uses soundwaves to show the uterus, bladder, and cervix
  • voiding cystourethrography, atestin which X-rays of the bladder are taken while the person urinates. This testallows the healthcare provider to see the shape of the bladder. It can alsoreveal any other reasons why the flow of urine is blocked.
  • urinalysis and urine culture, in which the urine is analyzed andexaminedfor bacteria
  • blood tests, including a complete blood count, or CBC, to check for infection
  • other X-rays, scans, or tests to rule out other causes of the symptoms

    • Prevention & Expectations

    What can be done to prevent the disease?

    A cystocele may not be preventable. Using caution when doing heavy lifting maydecrease the risk. Careful monitoring, and an episiotomy if necessary, may prevent acystocele during childbirth. Kegelexercises may strengthen the wallsupporting the vagina and bladder.

    A pessary may help keep a cystocele from becoming worse. This is a device thatcan be put into the vagina to hold the bladder in place.

    Staying active and eating a healthy diet with fiber, fruits, and vegetables may decrease constipation.

    What are the long-term effects of the disease?

    Long-term effects of a cystocele depend on the severity of the condition.A cystocele may lead to frequent urinarytractinfections. Embarrassment about leaking urine can cause stress. Otherlong-term effects depend on the success of treatment.

    What are the risks to others?

    A cystocele is not contagious and poses no risk to others.

    Treatment & Monitoring

    What are the treatments for the disease?

    Treatment of a cystocele is aimed at reducing symptoms. These measures may help:

  • avoiding straining during bowel movements or heavy lifting
  • doing Kegel exercises tostrengthen the muscles supporting the bladder and vagina
  • using a pessary, which is a device fitted into the vagina to hold thebladder in place
  • taking hormone replacement therapy, orHRT,for postmenopausal women, whichmayhelp to strengthen the muscles around the vagina and bladder
  • surgery for severe or persistent symptoms, orfor a progressivecystocele. The goal of the surgery is to move the bladder back into its normalposition and hold it there.
    • What are the side effects of the treatments?

    Side effects that can occur with hormone replacement therapy include vaginalbleeding, breast tenderness, weight gain, abdominal bloating, and headaches. Surgery carries a risk ofbleeding, infection, and allergicreactions to anesthesia.

    What happens after treatment for the disease?

    Treatment outcomes vary with the methods used to manage the cystocele. Forexample, the treatment of mild symptoms might include long-term activityrestrictions, such as the avoidance of straining and heavy lifting. A pessarymust be removed regularly to avoid infection or irritation of the lining of thevagina. Recovery from surgery may take a few days to several weeks, dependingon the procedure used.

    How is the disease monitored?

    Any new or worsening symptoms should be reported to the healthcare provider.

    Article type: xmedgeneral

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