The Right Cystocele Treatment for You: Factors to Consider and Recovery Tips
Cystocele is a condition characterized by slipping of the bladder down into the vaginal canal causing a bulge at the vaginal opening. It occurs when the tissues supporting a woman's bladder and vagina get stretched and weakened due to certain stresses like pregnancy, childbirth, post-menopausal hormonal changes after menopause, obesity, and severe coughing. In severe cases, the bladder tissues can even protrude out of the vaginal opening burdening activities of daily life.
Cystocele can cause great discomfort, pain during sex, and urinary or bowel problems. Fortunately, there are many different types of treatment options available for managing this condition, such as pelvic floor exercises, pessaries, external support devices, lifestyle changes, and surgery. A healthcare provider will consider several factors, like the severity of the condition and the individual's specific needs, while advising an appropriate treatment option. This article will explore the factors to consider while selecting the best course of action for treating cystocele and tips to recover from it.
Nonsurgical Treatment Options for Cystocele
Depending upon the severity of the condition and the person’s health status, cystocele can be treated using various nonsurgical approaches, such as:
- Pelvic floor therapy: Performing pelvic floor exercises like Kegels is a great way to strengthen muscles in the pelvic floor. It involves contracting and relaxing the pelvic floor muscles to strengthen the pelvic floor tissues supporting the bladder and vagina. This treatment method requires a lot of time and commitment as it may take a long time of consistent performance to see results.
- Pessary: Pessaries are silicon prosthetic devices inserted into the vagina to provide the necessary support to the pelvic floor tissues and prevent the organs from slipping into the vagina. These devices come in various shapes and sizes that are readily available. However, they need to be fitted by a healthcare provider and need to be replaced every 3-6 months. Unfortunately, not all women are able to get fitted for pessary use and there are some common negative sides effective of pessaries. Some of them include, bad odor, increased vaginal discharge, discomfort and pain.
- External Support Devices: There are many different prolapse support underwear and braces available on the market today. One of them is FemiCushion, a non-invasive and natural at home treatment option for women suitable for all types of pelvic organ prolapse. It is a great alternative treatment method, especially when you are not comfortable or are contraindicated for pessaries or surgical therapy. What sets this external support device apart from all the other ones on the market is the silicone cushion. FemiCushion uses a soft silicone cushion that forms to the shape of the body providing support to any prolapsed organs and preventing it from bugling out of the body. Women are able to get immediate prolapse relief with this device and it does not require a doctor’s prescription.
- Lifestyle modifications: After being diagnosed with pelvic organ prolapse it is important to make changes to your daily life to prevent the worsening of the prolapse. Avoiding heavy lifting, quitting smoking, maintaining a healthy weight, wear loose fitting clothes, and avoiding activities that put pressure on the pelvic area can also help manage symptoms of cystocele.
Surgical Treatment Options for Cystocele
For women who decide that undergo surgery, below are some surgery procedures that you doctors may discuss with you.
Anterior colporrhaphy: In this procedure, the surgeon makes an incision in the front of the vaginal wall to reposition the bladder to its usual position and tighten the muscles and tissues responsible for holding the bladder in place by using stitches.
Vaginal mesh placement: In this procedure, the surgeon makes three minor incisions (one in the vaginal area and two above the pubic bone) and places a thin strip of synthetic mesh beneath the urethra. This mesh elevates the bladder and provides the necessary support to pelvic floor tissues.
Sling procedures: In this procedure, a sling (a mesh-like material) is placed around the urethra to support the bladder and other pelvic floor organs. The surgeon can perform this procedure either by making an incision in the abdomen or the vaginal wall.
Recovery and Aftercare
The recovery process for surgery can vary depending on the severity of the cystocele and the type of treatment you receive. Typically, it takes about 4-6 weeks to recover completely. During the first few days post-surgery, you may experience some discomfort and minor bleeding or discharge. Your doctor will also advise avoiding strenuous activities and lifting heavy objects for a few weeks after surgery.
Sometimes, women may experience some side effects after surgical treatment, like:
- Pain or discomfort
- Difficulty urinating
- Bloody discharge
Discussing with your doctor will help you understand how to manage these side effects. Your doctor will probably prescribe you pain medications or advice you to use ice packs or other measures to ease the symptoms.
In some cases, cystocele may recur after treatment. It is important to do regular pelvic floor exercises, maintain a healthy weight, avoid strenuous activities, and treat chronic cough and constipation promptly to prevent recurrence. Your healthcare provider can provide additional guidance regarding reducing the risk of cystocele recurrence. You will also be asked to come for a few follow-up visits to monitor for any signs of recurrence and discuss any concerns you may have.
Choosing the Right Treatment Option for You
Cystoceles are often asymptomatic and get detected when you undergo a pelvic exam or ultrasonography. If you notice symptoms like heaviness in your lower abdomen, tissue hanging out of the vagina, difficulty in urination, or pain during sex, you should consult your physician immediately. Your healthcare provider will be able to diagnose and assess the condition and provide and inform you about the best treatment option.
Your physician will also ask you about your lifestyle, medical history, and preference before deciding on a treatment method for you. Typically, he will consider factors like your age, the severity of the condition, plans to have children, and your overall health when deciding on a treatment plan. In most cases, doctors advise non-surgical and non-invasive measures like pelvic floor exercises or pessary. However, for more advanced cases of cystocele, you may require surgery.
Cystocele can have a significant impact on a patient's quality of life. If you are experiencing symptoms of cystocele, we encourage you to talk to your doctor immediately. Leaving the prolapse on it own will most likely cause it to worsen over time. Your doctor will assess the severity of your cystocele and discuss the best treatment option for you with you. You do not have to suffer the burdens from pelvic organ prolapse alone. Many women around the world struggle with the same condition. It is only with prompt care, education, and treatment that women can return to a healthy pain free life.
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.