Understanding Cystocele: Causes, Diagnosis, and Treatment Options

What is a Cystocele?

Cystocele happens when the bladder sags or presses into the vagina. It is also called bladder prolapse.

Pregnancy, pelvic surgery, or being overweight may damage the muscles and other support tissues in your pelvis, or the muscles and tissues may weaken as you age. These can make the bladder sag. This may cause uncomfortable pressure in your vagina.

A cystocele usually does not cause serious health problems. You may find relief by making lifestyle changes and exercising to strengthen the pelvic muscles. Talk to your doctor about steps you can take to reduce symptoms. You may want to talk to your doctor about surgery if your symptoms worsen.

Causes of Cystocele

A cystocele, also known as a fallen bladder or prolapsed bladder, occurs when the wall between a woman's bladder and vagina weakens, causing the bladder to sag into the vaginal space. This can lead to discomfort, urinary leakage, and other issues.

Common causes include:

1. Heavy Lifting: Regularly engaging in heavy lifting can strain the pelvic muscles, increasing the risk of bladder prolapse.
2. Childbirth: The strains of childbirth, particularly if the muscles around the vagina are strained during delivery, can weaken the support for the bladder.
3. Bowel Movements: Repeatedly straining during bowel movements can exert pressure on the pelvic region and contribute to the weakening of muscles.
4. Menopause: Estrogen, a hormone that helps maintain muscle strength around the vagina, decreases after menopause. This hormonal change can lead to muscle weakening and an increased risk of a cystocele.

Diagnosing a Cystocele

A cystourethrogram, also known as a voiding cystogram, may be conducted in some cases. This procedure involves an X-ray of the bladder during urination, using a contrast liquid to highlight the bladder's shape and potential obstructions.  If you suspect you may have a cystocele, it's important to seek proper medical evaluation and diagnosis. Your healthcare provider typically begins with a comprehensive medical history and physical examination.

Your doctor may recommend further tests to evaluate your overall urinary system's health and identify any other potential issues.

Levels of Cystoceles

Cystoceles are categorized into three grades based on severity:

• Grade 1 - Mild: The bladder slightly droops into the vagina.
• Grade 2 - Moderate: The bladder has descended further, reaching the vaginal opening.
• Grade 3 - Severe: The bladder bulges out through the vaginal opening.

Treatment Options

The appropriate treatment for your cystocele will depend on various factors, including age, overall health, and personal preferences.  Treatment options include:

• Activity Modification: Avoiding heavy lifting and straining can help prevent the cystocele from worsening.
• Pessary: A pessary is a device placed in the vagina to support and keep the bladder in place.
• Surgery: In more advanced cases, surgical intervention may be recommended to reposition the bladder and restore its normal placement.
• Estrogen Replacement Therapy: Hormone replacement therapy, including estrogen, can help strengthen the muscles around the vagina and bladder. The decision to pursue this therapy should be made in consultation with your healthcare provider, weighing the benefits against potential risks.

Empowering Your Health

Cystocele might not be a commonly discussed topic, but understanding its causes, diagnosis, and treatment options is vital for your well-being. If you're experiencing symptoms like pelvic discomfort, urinary issues, or a noticeable discomfort in the vaginal area, don't hesitate to contact a healthcare professional. Contact your primary care physician to schedule a consultation or to request a referral to a urogynecologist and take proactive steps toward your well-being.