Cystocele, or a dropped bladder, occurs when muscles and ligaments in the pelvic region are compromised, often due to pregnancy and childbirth. Symptoms include loss of bladder control and discomfort during sexual activity. Treatment options include Kegel exercises, estrogen therapy, a pessary, or surgery.
A cystocele is a condition commonly described as a dropped bladder in women. The latter term is a bit of a misnomer, as the bladder doesn’t actually collapse and stop functioning. However, the bladder can protrude and penetrate the vaginal wall, which is positioned just below the bladder. For this reason, a cystocele is often referred to as a herniated or prolapsed bladder.
A cystocele occurs due to torn or strained muscles and ligaments, leading to compromised support for the organs in the pelvic region. In general, pregnancy and childbirth are the main reasons for this development. However, not all women who have given birth experience this condition. For example, cystoceles are rarely seen in women who have delivered babies by cesarean section. Other factors can also contribute to the development of cystocele, including hysterectomy, obesity, strenuous lifting, straining to have a bowel movement, and even coughing.
The risk increases with age, especially after menopause. This is because estrogen levels, which previously helped maintain the integrity of the pelvic floor muscles, begin to decline. Trauma or injury to the pelvic area can also cause this condition.
For many women, a cystocele can go unnoticed for some time. In fact, some women may view symptoms as a reward for aging and simply ignore them, such as the frequent need to urinate. The most common sign that a cystocele is pending is loss of bladder control while sneezing, coughing, or laughing. However, in advanced cases, it is possible for the protruding bladder to penetrate the vaginal opening or even to aggregate with other organs in an anterior prolapse into the vagina.
It is important to seek medical treatment if a cystocele is suspected. Left untreated, this condition can lead to frequent bladder infections and even complete loss of bladder control. In some cases, the protrusion can cause significant pain and discomfort, particularly during sexual activity. Typically, a physical exam is all that is needed to get a diagnosis.
Treatment varies depending on how far the cystocele has progressed. Kegel exercises, designed to strengthen the pelvic muscles, are almost always recommended. Estrogen therapy may also be an option to consider. In some cases, a ring known as a pessary may be implanted in the vagina to provide support for the bladder above.
Surgery may be the best course of action to remedy a severe cystocele. In this procedure, the surgeon repositions the bladder in the correct position while repairing the vaginal wall and underlying muscles if necessary. However, surgery is not a guarantee that another cystocele won’t occur in the future. Indeed, it is important to follow preventive measures after treatment of any kind to discourage a recurrence.
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