Cystocele is a condition in which part of the bladder drops down, or protrudes, into the wall of the vagina.
The bladder is the holding place for urine. It lies just above the vagina in a female. Between the bladder and vagina is a wall made of tissues and muscles that support the bladder and the urethra. The urethra is a tube that carries urine from the bladder to the outside of the body.
When a woman has a cystocele, the wall supporting the bladder is weaker than usual. This weakening allows part of the bladder to protrude or drop down into the vagina. As the bladder droops into the vagina, the urethra becomes stretched, allowing urine to leak out of the urethra.
A cystocele results from a weakening or stretching of the tissues supporting the bladder. The causes of this weakening include:
The 2 most common symptoms of cystocele are:
Other symptoms may include:
Diagnosis begins with a complete history and physical, including a pelvic exam. Other tests may include:
A cystocele may not be preventable. Using caution when doing heavy lifting may decrease the risk. Careful monitoring, and an episiotomy if necessary, may prevent a cystocele during childbirth. Kegel exercises may strengthen the wall supporting the vagina and bladder.
A pessary may help keep a cystocele from becoming worse. This is a device that can be put into the vagina to hold the bladder in place.
Staying active and eating a healthy diet with fiber, fruits, and vegetables may decrease constipation.
Long-term effects of a cystocele depend on the severity of the condition. A cystocele may lead to frequent urinary tract infections. Embarrassment about leaking urine can cause stress. Other long-term effects depend on the success of treatment.
A cystocele is not contagious and poses no risk to others.
Treatment of a cystocele is aimed at reducing symptoms. These measures may help:
Side effects that can occur with hormone replacement therapy include vaginal bleeding, breast tenderness, weight gain, abdominal bloating, and headaches. Surgery carries a risk of bleeding, infection, and allergic reactions to anesthesia.
Treatment outcomes vary with the methods used to manage the cystocele. For example, the treatment of mild symptoms might include long-term activity restrictions, such as the avoidance of straining and heavy lifting. A pessary must be removed regularly to avoid infection or irritation of the lining of the vagina. Recovery from surgery may take a few days to several weeks, depending on the procedure used.
Any new or worsening symptoms should be reported to the healthcare provider.
Author:Eileen McLaughlin, RN, BSN
Editor:Ballenberg, Sally, BS
Reviewer:Barbara Mallari, RN, BSN, PHN
http://www.niddk.nih.gov/health/urolog/summary/cystocel/index.htm. Harrison's Principles of Internal Medicine, 1998, Fauci et al.