A cystocele is a condition commonly described as a fallen bladder in women. The latter term is a bit of misnomer, though, since the bladder doesn’t actually collapse and cease functioning. However, the bladder may protrude and penetrate the vaginal wall, which is positioned just underneath the bladder. For this reason, a cystocele is often referred to as a herniated or prolapsed bladder.
A cystocele occurs as the result of torn or stressed muscles and ligaments, leading to compromised support for the organs of the pelvic region. Generally, pregnancy and childbirth are the primary reasons for this development. However, not all women that have given birth experience this condition. For instance, cystoceles are rarely seen in women that have delivered children by Cesarean section. Other factors can contribute to cystocele development, too, including hysterectomy, obesity, strenuous lifting, excessive straining to have a bowel movement, and even coughing.
Risk increases with age, especially after menopause. This is because estrogen levels, which previously helped to preserve the integrity of the pelvic floor muscles, begin to fall off. Trauma or injury to the pelvic area may also cause this condition.
For many women, a cystocele can go undetected for some time. In fact, some women may regard symptoms as a reward for getting older and simply ignore them, such as the frequent urge to urinate. The most common sign that a cystocele is pending is loss of bladder control while sneezing, coughing, or laughing. However, in advanced cases, it’s possible for the protruding bladder to penetrate the vaginal opening, or even congregate with other organs in an anterior prolapse in the vagina.
It’s important to seek medical treatment if a cystocele is suspected. Left untreated, this condition can produce frequent bladder infections and even complete loss of bladder control. In some cases, the protrusion can cause considerable pain and discomfort, particularly during sexual activity. Generally, a physical examination is all that’s needed to obtain a diagnosis.
Treatment varies according to how far the cystocele has progressed. Kegel exercises, which are designed to strengthen the pelvic muscles, are almost always recommended. Estrogen therapy may also be an option to consider. In some cases, a ring known as a pessary may be implanted into the vagina to provide support for the bladder above.
Surgery may be the best course of action to remedy a severe cystocele. In this procedure, the surgeon repositions the bladder to its proper place while repairing the vaginal wall and underlying muscles, if necessary. However, surgery is not a guarantee that another cystocele won’t occur in the future. In fact, it’s important to follow up with preventative measures after treatment of any kind to deter a recurrence.