Cystocele Definition, Reason, Symptoms, Treatment & Prevention
Definition
Cystocele or bladder prolapse is the displacement of the bladder downward towards the vagina. So that it can cause problems such as difficulty urinating (BAK), discomfort when urinating, and urinary incontinence (leakage of urine when sneezing or coughing).
Cystoceles are divided into four degrees based on how far the prolapse is, namely:
- Stage 1 (mild), where only a small part of the bladder prolapses into the vagina
- Stage 2 (moderate), a condition in which the bladder prolapses to the opening of the vagina
- Stage 3 (severe), a condition in which the bladder protrudes from the body through the vaginal opening
- Stage 4 (total), in which the entire bladder protrudes completely outside the vagina, is usually associated with prolapse of other pelvic organs such as uterine (womb) prolapse, etc.
Cystocele is usually associated with menopause. During menopause, the hormone estrogen decreases. This hormone helps the muscles in and around the vagina stay strong. So that at the time of menopause, the muscles tend to weaken.
Cystocele Symptoms
In the first or mild stages, it may not give any symptoms. The first known symptom of a cystocele is the appearance of tissue or a bulge in the vagina that feels like a ball. The bulge may be painful when pressed and may bleed.
Other symptoms that can appear include:
- Discomfort and pain in the pelvis or pelvis
- Difficulty for BAK
- Feeling sluggish or not light when urinating
- Urinary incontinence (leakage of urine when sneezing or coughing)
- Recurrent urinary tract infections (UTIs).
- Dyspareunia or pain during intercourse
- Lower back pain or low back pain (LBP)
Cystocele Reason
A cystocele occurs because the front wall of the vagina becomes weak so that it can no longer support the location of the bladder. Weakness of the wall can occur due to:
- aging process or menopause
- Excessive stress can damage the vaginal walls, such as during childbirth
- excess pressure such as when lifting heavy loads, straining when having a bowel movement, having a long-standing cough, or old constipation
Diagnosis
Doctors can usually determine the diagnosis of cystocele or bladder prolapse from the patient’s history and symptoms. The doctor will carry out a physical examination to look for possible prolapse of other pelvic organs.
Investigation can be done for difficult cases. Voiding cystourethrogram, which is an X-ray that is done when the patient has BAK, can be done to check the shape of the bladder and the cause of BAK disorders. A urodynamic examination is performed to measure the pressure and volume of the bladder.
Cystoscopy examination is done by inserting a camera tube into the bladder. This examination is usually to determine treatment.
Cystocele Treatment
In the first stage usually does not require treatment. However, sufferers should avoid activities that put pressure. For other stages, treatment may include:
- pessary: a restraint device inserted through the vagina to hold the bladder in place
- Estrogen replacement therapy to strengthen the muscles in the vagina
The pessary needs to be removed and cleaned regularly to prevent infection. Kegel exercises can strengthen the pelvic muscles and are useful in patients with mild to moderate cystocele.
In more severe stages, surgery can be done. Surgery is performed vaginally and returns the bladder to its original position. Other treatments such as electrical stimulation can be done to strengthen the vaginal muscles.
Prevention
Some causes of cystoceles such as aging cannot be avoided. Cystocele can be prevented by:
- prevent constipation with a high-fiber diet and drink lots of water
- avoid straining during bowel movements
- avoid lifting heavy weights
- avoid obesity