Cystocele | Causes, Symptoms, And Diagnosis: Doctor’s Advice
Cystocele | Causes, Symptoms, and Diagnosis: Doctor’s Advice
Many women, especially those who have children, are affected by a cystocele or some degree of pelvic organ prolapse in their lifetimes, however, the condition often goes untreated as the symptoms are not properly recognized or reported to their doctors. Although a cystocele is not life threatening, it can negatively impact a woman’s quality of life and can worsen if not treated.
What Is the “Cystocele”?
Also known as a prolapsed bladder, anterior vaginal wall prolapse, or fallen bladder, a cystocele refers to a condition in which the connective and supportive tissues around the bladder and vaginal wall weaken and stretch. When these ligaments reach a certain point of weakness, the bladder and vaginal wall are allowed to fall or “sag” into the vaginal canal.
Health care professionals rank cystoceles using three stages or grades. Grade 1 is considered a mild case with the bladder dropping only a short way into the vagina. Grade 2 is moderate as the bladder descends further. In Grade 3 the bladder and vaginal wall have dropped down far enough to bulge into the vaginal canal and possibly out through the opening of the vagina. The most serious stage is Grade 4, in which pelvic organs protrude out of the vagina.
Why Am I Having a Cystocele? – Causes of Cystocele
As mentioned above, a cystocele is caused by the damaging and weakening of certain muscles and connective tissues. There are multiple factors that may contribute to this such as:
- Estrogen levels decreasing with age/menopause
- Vaginal birth
- Hysterectomy
- Obesity
- Family history
- Intense physical activity, including lifting heavy objects
- Constipation and/or repeated muscle straining during bowel movements
- Frequent coughing
The Symptoms of a Cystocele
Women with a cystocele can experience a range of symptoms. A few commonly reported include:
- Difficulty urinating or emptying the bladder
- Frequent urination or the sensation of needing to go frequently
- Recurring urinary tract infections
- Pain during sexual intercourse
- Trouble inserting tampons or applicators
- Feeling full or heavy heaviness in the pelvic area
- Pain in the lower back
- Seeing or feeling something through the vaginal opening
Therapy and Self Care for Difficulty Urinating
Depending on the grade and severity of symptoms, a mild cystocele may not require treatment. However, precautions should be taken to avoid heavy lifting or straining as these could cause the condition to get worse. Weight loss may also be advised to help alleviate symptoms. Some women undergo estrogen replacement therapy, which is primarily used to treat symptoms of menopause.
All women should practice Kegel exercises to help strengthen the muscles surrounding the openings of the urethra, vagina, and rectum. These can help reduce unwanted urination symptoms and similar difficulties while also supporting pelvic floor health.
Another typical care route for a cystocele is a pessary. Available in several shapes and sizes to ensure a proper fit, this device may be inserted in the vagina to hold the bladder in place. Although a pessary does not cure or reverse a prolapse, the extra support it gives can help relieve symptoms. Pessaries must be removed on regular basis for cleaning to avoid infection or ulcers.
For women who prefer a non-invasive alternative to a pessary or surgery, there’s FemiCushion. Designed to provide natural support from beneath the vaginal opening, this discreet device is easier and more comfortable to wear than traditional pessaries. If you would like to learn more about this innovative, non-invasive solution to pelvic organ collapse, please refer to our frequently asked questions page or contact us today!
Supervising Doctor of This Article
Koichi Nagao, MD PhD
Professor, Department of Urology, Toho University Faculty of Medicine
Director of Urinary tract reconstruction center, Toho University Omori Medical Center
Director of Reproduction Center, Toho University Omori Medical Center
Professor Nagao specializes in plastic surgery in the field of reproductive medicine. He completed eight years of plastic surgery training at Showa University before majoring in urology at Toho University. With his meticulous surgical techniques and careful examinations that combines urology and plastic surgery, Professor Nagao became a Board Certified Specialist with multiple associations including the Japanese Urological Association, the Japan Society for Reproductive Medicine, and the Japanese Society for Sexual Medicine.