Cystocele is the condition where the bladder prolapses toward the vagina. This condition belongs to pelvic organ prolapses and often appears in women after childbirth or after menopause, but also in nulliparous women of reproductive age who have risk factors.
The bladder is supported in its normal position by supporting tissues, such as the pelvic floor muscles, ligaments, and peritoneum. When these supporting tissues weaken or sustain injuries, the bladder can "slip" from its normal position and protrude into the vagina.
Degrees of Cystocele
Cystocele is classified into four degrees of severity:
The most common symptoms of cystocele include:
The weakening of the bladder support mechanism results in bladder prolapse. This weakening occurs due to:
Clinical Examination
The diagnosis of cystocele is made through clinical examination by a specialized urogynecologist.
Supplementary Tests
Conservative Treatment for First or Second Degree Cystocele
Kegel exercises are the first line of treatment for mild cases of cystocele. These exercises strengthen the pelvic floor muscles and can reduce symptoms, prevent worsening, and improve the woman's quality of life.
The vaginal pessary is a non-surgical therapeutic solution, a device placed in the vagina that provides mechanical support. It is suitable for women who are not candidates for surgery and requires regular cleaning and monitoring.
Surgical Treatment
Indications for Surgery
Surgical treatment is recommended when:
Anterior colporrhaphy is the treatment of choice. The anterior vaginal wall is reinforced and the cystocele is corrected. The procedure is performed only with vaginal approach, recovery is immediate, and healing is rapid. There are no external visible incisions.
Long-term Prognosis
With appropriate therapeutic management, all affected women can have healing with excellent long-term results.
Immediate medical advice is recommended when:
Early diagnosis and treatment of cystocele is critical for preventing complications and improving quality of life. A scientific approach by a specialized urogynecologist such as, offers proper diagnosis and selection of the appropriate therapeutic method, which are key to successful management of this common and unpleasant condition.
Discuss with Kostis Nikolopoulos the therapeutic approach that suits you.
