Summary about Disease
A cystocele, also known as a prolapsed bladder, occurs when the supportive tissue between a woman's bladder and vaginal wall weakens and stretches. This allows the bladder to sag or bulge into the vagina. Cystoceles can range from mild to severe, depending on how far the bladder has dropped.
Symptoms
Symptoms can vary depending on the severity of the cystocele. Some women with mild cystoceles may not experience any symptoms. Common symptoms include:
Feeling a bulge or pressure in the vagina
Difficulty starting urination
Frequent urination
Urgent need to urinate
Feeling like the bladder is not completely empty after urination
Stress incontinence (leaking urine when coughing, sneezing, or laughing)
Painful sexual intercourse
Recurrent bladder infections
Causes
Several factors can contribute to the weakening of the supportive tissues leading to a cystocele:
Childbirth: Vaginal childbirth, especially multiple births, can stretch and weaken the pelvic floor muscles.
Aging: As women age, estrogen levels decrease, which can weaken pelvic floor tissues.
Chronic coughing or straining: Conditions like chronic bronchitis or constipation can increase pressure on the pelvic floor.
Obesity: Excess weight puts added strain on the pelvic floor.
Heavy lifting: Regularly lifting heavy objects can weaken pelvic floor muscles.
Genetics: Some women may have a genetic predisposition to weaker pelvic floor tissues.
Hysterectomy: Removal of the uterus can sometimes weaken the pelvic floor support.
Medicine Used
Medications are not typically used to cure a cystocele but can help manage symptoms.
Estrogen therapy: Topical estrogen cream or vaginal rings can help strengthen the tissues in the vagina and urethra, particularly after menopause.
Medications for overactive bladder: If urgency and frequency are prominent symptoms, medications like antimuscarinics (e.g., oxybutynin, tolterodine) or beta-3 adrenergic agonists (e.g., mirabegron) might be prescribed. Important Note: Surgery or a pessary is usually required to correct the prolapse itself, not medications. Medications are often used for symptomatic relief.
Is Communicable
No, a cystocele is not communicable. It is a structural problem and not caused by an infectious agent.
Precautions
Preventative measures and lifestyle changes can help reduce the risk of developing a cystocele or prevent it from worsening:
Kegel exercises: Regularly performing Kegel exercises strengthens pelvic floor muscles.
Maintain a healthy weight: Losing weight can reduce pressure on the pelvic floor.
Avoid heavy lifting: Use proper lifting techniques and avoid lifting heavy objects if possible.
Treat chronic cough: Seek medical treatment for chronic coughing.
Prevent constipation: Eat a high-fiber diet and drink plenty of fluids to prevent constipation.
Estrogen therapy: If postmenopausal, discuss estrogen therapy with a doctor.
How long does an outbreak last?
A cystocele is not an "outbreak" – it's a structural issue that develops over time. The symptoms can be chronic (long-lasting) and may worsen gradually. Symptoms can fluctuate depending on factors like activity level or hormonal changes. Without intervention (e.g., lifestyle changes, pessary, or surgery), the cystocele persists.
How is it diagnosed?
Diagnosis typically involves:
Pelvic exam: A physical examination by a doctor can often reveal the prolapse.
Patient History: The doctor will ask about symptoms, childbirth history, and other relevant medical information.
Cystoscopy: A small camera is inserted into the bladder to visualize the bladder lining.
Urodynamic testing: These tests measure bladder function and can help identify any bladder control problems.
Voiding cystourethrogram (VCUG): X-ray of bladder while urinating.
MRI: Magnetic Resonance Imaging may be performed in rare instances to assess prolapse.
Timeline of Symptoms
The timeline of symptoms is variable.
Early stages: Many women have no symptoms or very mild ones. They might only notice a slight pressure or bulge occasionally, especially after physical activity.
Progression: Over time, the bulge may become more noticeable and persistent. Urinary symptoms like frequency, urgency, or incomplete emptying may develop.
Advanced stages: The bulge may protrude significantly from the vaginal opening. Urinary incontinence, painful intercourse, and recurrent bladder infections become more common. The progression is influenced by individual factors like childbirth, age, weight, and activities.
Important Considerations
Severity: Cystoceles are graded based on severity.
Other pelvic organ prolapse: Cystoceles often occur with other types of pelvic organ prolapse (e.g., rectocele, uterine prolapse).
Treatment options: Treatment options range from conservative measures (Kegel exercises, pessary) to surgical repair. The best treatment depends on the severity of the cystocele, the patient's symptoms, and her overall health.
Quality of Life: Cystoceles can significantly impact quality of life due to urinary symptoms and discomfort.
Discuss treatment options with a qualified healthcare professional. Self-treating can worsen the condition.