What is Cystocele?
A cystocele is also known as a herniated or fallen bladder. The bladder is the part of the body where urine is stored. The bladder is held together by muscles and ligaments within the woman’s vagina. When this ligament that holds the bladder weakens or stretches the bladder begins to sag into the vagina and this condition is called the fallen bladder. There are three types of cystocele and are determined based on the grades:
- Grade 1 (Mild): The bladder falls a small distance into the vagina.
- Grade 2 (Moderate): It falls to the vaginal opening.
- Grade 3 (Severe): It extends into the vaginal opening.
The most common symptom of a fallen bladder is that the vaginal bulge can be felt:
- Frequent and urgent urination
- Pain in the back especially lower back
- A vaginal bulge that can be seen or felt
- Urine leakage and inability to empty the bladder completely.
- Pain in the pelvis and lower belly and/or feeling of pressure.
- Urinary tract infections occur frequently
- The organs have to be pushed back to have a bowel movement or to empty the bladder.
- Standing, sitting or coughing increases pressure on the pelvic.
In some cases, women do not have any signs or have symptoms like frequent urination which can be for many other reasons.
Who is at Risk?
The risk factors of cystocele are high in:
- Women who have had many vaginal deliveries which results in weakening of the pelvic muscles.
- Older women whose muscles, tissues and ligaments weaken due to age or other health issues.
- Family history. If a close family relative has this condition, such people are at a high risk of this condition
- Women who are overweight or obese.
- Women who suffer from hormonal imbalance.
- Women who suffer from conditions like chronic coughing, constipation, applying too much pressure while passing stools, etc.
- Women who lift heavy objects that put pressure on the pelvis.
The pelvic floor muscles and the endopelvic fascia support the urinary bladder and the other pelvic organs in females. Sometimes these pelvic muscles become weak or get stretched excessively causing the bladder to bulge through the vagina causing the formation of cystoceles. The causes of cystocele can be due to:
- Chronic strain to the pelvic floor muscles due to straining to pass stools, constipation or chronic cough.
- Vaginal delivery leads to stretching of the pelvic floor muscles and is one of the most common reasons.
- Conditions like Marfan syndrome, Joint hypermobility syndrome, Ehlers-Danlos syndrome cause weakening of connectivity tissues and hence cystocele.
- Congenital weakness of the pelvic floor muscles.
- Being overweight or obese
- Lifting heavy objects which results in stretching of the muscles.
How is a Cystocele diagnosed?
Cystocele Diagnosis is done by doing the following tests:
- A urologist will look into the medical history, understand the symptoms and then performs a physical examination. The urinary bladder is felt by the doctor and the grading is done based on how much the bladder has bulged.
- Ultrasound is ordered to check the amount of urine retained in the bladder after passing urine.
- Bladder catheterization is done to drain the urine as a precaution after the procedure.
- Coding cystourethrogram is performed to determine the effect of cystocele on the bladder.
- MRI may be done to check if there are any issues with the urinary system.
How is Cystocele Treated?
Cystocele treatment includes the following:
- The doctor recommends certain changes like avoiding lifting heavy objects or asks to reduce the strain during bowel movements by incorporating healthy food habits.
- A small device called a pessary is placed in the vagina so that it holds the bladder in place.
- Kegel exercises to make the pelvic muscles strong.
- Hormone replacement therapy to keep the levels of the hormone optimal.
- Severe forms may need surgery as Cystocele cure where the bladder is moved back to the normal position.
If you are suffering from urinary incontinence or frequent urination, consult our urologist at Cure.fit to determine if it is a cystocele. They are available through video consultations too!
How to Prevent Cystocele?
Some of the steps for prevention of cystocele are:
- To get proper and early treatment of chronic cough and constipation which are some of the main causes for cystocele.
- Use family planning methods to prevent frequent deliveries which cause stretching of pelvic muscles.
- Include Kegel exercises as part of your regular exercise regimen to increase the strength of pelvic muscles and prevent cystocele.
- Maintain a healthy weight by following a healthy lifestyle.