Unfortunately, many women at a certain stage of life have to deal with such an unpleasant problem as cystocele. What it is? This is a hernia of the bladder, which appears after stretching the supporting tissue between this organ and the vaginal wall, because of which the bladder protrudes down into the vagina.
The main reason for the appearance of such a problem is the stretching of the muscles supporting the pelvic organs. Childbirth in the natural way, chronic constipation, prolonged severe coughing or weight lifting can lead to distension. In addition, the menopause is considered an additional risk factor when estrogen levels in the body decrease.
If a woman is diagnosed with a mild or moderate bladder hernia, doctors usually prescribe conservative treatment. In more severe cases, surgery may be required to hold the vagina and other pelvic organs in the right places.
Symptoms
It is possible that with a mild degree of prolapse of the bladder, you will not even feel the development of cystocele. Symptoms and signs of pathology can be expressed in different ways and usually include:
- a feeling of fullness or pressure in the pelvis and vagina;
- increased discomfort with stress, coughing, trying or lifting weights;
- the feeling that you have not completely emptied your bladder after using the toilet;
- recurrent urinary tract infections;
- pain or mild urinary incontinence during intercourse.
In severe cases, a fragment of tissue bulging through the vaginal opening becomes noticeable, and a feeling of sitting on a chicken egg may appear.
Signs of pathology are especially clearly noted after a long standing on legs and can pass after taking a prone position.
When to see a doctor
Serious discomfort is the main problem that cystocele brings with it. Degrees of disease can progress and lead to difficulty in emptying the bladder and recurring infections. If you have symptoms that cause you concern, sign up for a specialist consultation.
Causes
The pelvic floor consists of muscles, ligaments and connective tissues supporting the bladder and other pelvic organs. The joints between the muscles and ligaments can weaken over time as a result of birth trauma or chronic pelvic floor muscle strain. When this happens, the bladder can fall below normal and literally fall out into the vagina. This condition is called a bladder hernia - cystocele (photo).
Among the possible reasons are the following circumstances:
- pregnancy and natural birth;
- overweight or obesity;
- frequent weight lifting;
- bowel movements, constipation;
- chronic cough or bronchitis.
Risk factors
It is quite possible to prevent the development of pathology if you only recently learned about the existence of the term "cystocele". What is it and how to prevent a problem? Pay particular attention to risk factors that increase the likelihood of a bladder hernia. It:
- Childbirth. Most often, cystocele is found in women who have given birth to more than one child in a natural way.
- Body aging. The risk of a bladder hernia increases in direct proportion to the patient's age. The postmenopausal period is especially dangerous, since after menopause the production of estrogen, which supports the elasticity of the pelvic floor, decreases.
- Surgical removal of the uterus.
- Genetic features. An increased risk of pathology is noted in women born with weak connective tissues.
- Obesity. Cystocele also poses a risk to patients with a diagnosis of obesity and simply being overweight.
Diagnostics
The doctor must diagnose the problem before prescribing treatment based solely on the signs of cystocele - what it is and what kind of disease is the discomfort tormenting you, only a specialist can determine. For this, relevant studies and analyzes are carried out, including:
- Pelvic examination. Such an examination can take place in two positions of the patient: standing and lying. The doctor will look for obvious signs of a hernia, including bulging a piece of tissue in the vagina. Most likely, the specialist will ask you to bother, as when visiting the toilet, to reveal: how much such attempts affect the degree of cystocele; what is it - a variation of the norm or an obvious pathology. To check the strength of your pelvic floor muscles , your doctor will ask you to contract them, as if trying to stop urination.
- Urinalysis and bladder function. If you find a severe cystocele, you will be prescribed a study of the function of the bladder, that is, the quality of the organ emptying during urination. A urinalysis will be needed to identify possible infectious diseases if it turns out that more urine is left in the body after emptying than it should.
Treatment
If your diagnosis is cystocele, treatment will depend on the degree of prolapse of the bladder and the presence or absence of concomitant pathologies such as prolapse of the uterus into the vagina (prolapse of the uterus).
Small hernias with mild symptoms or a complete absence of signs of impairment usually do not require therapy. Experts recommend simply visiting the doctor from time to time to monitor the progression of the hernia and to take independent measures for treatment, namely, to strengthen the pelvic floor muscles with the famous Kegel exercises. If independent measures do not help, treatment may be as follows:
- Installing a supporting device (pessary). A vaginal pessary is a plastic or rubber ring that is inserted into the vagina to keep the bladder in place. Installation is done by a specialist who will show you how to remove, clean and reinsert the ring. Many women use the pessary as a temporary alternative to surgery.
- The use of estrogen. Your doctor may recommend the use of medications containing estrogen in the form of a vaginal ointment or tablets specifically for the treatment of cystocele. Reviews about specific medicines can be read in advance on thematic forums. Such therapy is especially useful after the patient has reached menopause.
Surgery
If you experience significant discomfort due to symptoms characteristic of the bladder hernia, surgery may be needed to fix the problems.
Usually, the operation is performed inside the vagina and involves the return of the bladder to its normal position, removal of excess tissue and tension of the muscles and ligaments of the pelvic floor. You may need to use special tissue flaps (grafts) to strengthen and provide additional support for vaginal tissues.
Features
If you are diagnosed with uterine prolapse, in addition to surgery on the pelvic tissue, your doctor will recommend removing the uterus.
If you are planning a pregnancy but still suffer from the characteristic signs of cystocele, surgery may be delayed until you decide that you no longer want to have children. Symptomatic treatment at this time is carried out using a pessary.
The effect of competent surgical intervention can last for many years, however, unfortunately, no one is immune from the recurrence of pathology. In this case, experts will advise you to lie down for another operation.