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 a
female. Between the bladder and vagina is a wall made of tissues and muscles
that support the bladder and the urethra. The urethra is a tube that carries
urine from the bladder to the outside of the body.
When a woman has a cystocele, the wall supporting the bladder is weaker than
usual. This weakening allows part of the bladder to protrude or drop down into
the vagina. As the bladder droops into the vagina, the urethra becomes
stretched, 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 the
bladder. The causes of this weakening include:
muscles and tissues being stretched during childbirth
heavy lifting that causes stress on the muscles surrounding the vagina and
bladder
repeated straining during bowel movements, which can be caused by frequent
constipation
menopause. Estrogen helps keep
the
muscles around the bladder and vagina strong. During menopause, estrogen levels
decrease.
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, a
condition
that 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 sound
waves to show the uterus, bladder, and cervix
voiding cystourethrography, a
test
in which X-rays of the bladder are taken while the person urinates. This test
allows the healthcare provider to see the shape of the bladder. It can also
reveal any other reasons why the flow of urine is blocked.
urinalysis and urine culture, in which the urine is analyzed and
examined
for 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 may
decrease the risk. Careful monitoring, and an episiotomy if necessary, may prevent a
cystocele during childbirth. Kegel
exercises may strengthen the wall
supporting the vagina and bladder.
A pessary may help keep a cystocele from becoming worse. This is a device that
can 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 urinary
tract
infections. Embarrassment about leaking urine can cause stress. Other
long-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 to
strengthen the muscles supporting the bladder and vagina
using a pessary, which is a device fitted into the vagina to hold the
bladder in place
taking hormone replacement therapy, or
HRT,
for postmenopausal women, which
may
help to strengthen the muscles around the vagina and bladder
surgery for severe or persistent symptoms, or
for a progressive
cystocele. The goal of the surgery is to move the bladder back into its normal
position and hold it there.
What are the side effects of the treatments?
Side effects that can occur with hormone replacement therapy include vaginal
bleeding, breast tenderness, weight gain, abdominal bloating, and headaches. Surgery carries a risk of
bleeding, infection, and allergic
reactions to anesthesia.
What happens after treatment for the disease?
Treatment outcomes vary with the methods used to manage the cystocele. For
example, the treatment of mild symptoms might include long-term activity
restrictions, such as the avoidance of straining and heavy lifting. A pessary
must be removed regularly to avoid infection or irritation of the lining of the
vagina. Recovery from surgery may take a few days to several weeks, depending
on the procedure used.
How is the disease monitored?
Any new or worsening symptoms should be reported to the healthcare provider.
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