Cystocele is also commonly known as bladder prolapsed or fallen bladder.

According to the University of Maryland Medical Center (UMM) ʺA cystocele is a downward outpocketing (hernia) of the bladder towards the vaginal opening. The weakening of the muscular wall in this condition can cause urine to leak from the bladder when there is an increase in internal abdominal pressure, such as in sneezing or coughing.ʺ

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), website revealed ʺA cystocele may result from muscle straining while giving birth. Other kinds of straining-such as heavy lifting or repeated straining during bowel movements-may also cause the bladder to fall. The hormone estrogen helps keep the muscles around the vagina strong. When women go through menopause-that is, when they stop having menstrual periods-their bodies stop making estrogen, so the muscles around the vagina and bladder may grow weak.ʺ

A cystocele may be diagnosed by your doctor in the following manners:

• A physical examination of the vagina
• A voiding cystourethrogram test
• Grade 2 or grade 3 cystocele can be diagnosed by a description of your symptoms

For a mild cystocele (grade 1) no treatment may be recommended by your doctor if it is not bothersome. He may suggest avoiding heavy lifting or straining. A pessary device may be tried if symptoms are more bothersome which is placed inside the vagina to help hold the bladder in place during the day time.

If you have grade 2 or 3 cystocele, your bladder will be visible during your vaginal examination. An X-ray of your bladder during urination is known as a voiding cystourethrogram.

The UMM website stated, ʺanterior vaginal wall repair surgery may help this condition.ʺ

This type of surgery is known as :

• A/P repair
• Vaginal wall repair
• Anterior and/or posterior vaginal wall repair
• Colporrhaphy or repair of vaginal wall
• Cystocele repair

The cystocele repair surgery is generally conducted when you are under spinal or general anesthesia. According to the UMM website, ʺWith spinal anesthesia, you will be awake, but you will be numb from the waist down and you will not feel pain. Under general anesthesia, you will be asleep and unable to feel pain.ʺ

The following occurs as a result of the cystocele procedure:

• An incision is made through the front wall of your vagina
• Or your doctor also makes a surgical up and down or across cut in your belly
• Your bladder is moved back to its normal location
• Your vaginal wall may be folded, or part of it may be cut away
• Your doctor may place human-made (synthetic) material between your bladder and vagina
• Sutures (stitches) are made in the tissue between your vagina and bladder
• These will hold the walls of your vagina in the correct position
• If needed, sutures attach the walls of the vagina to the tissue on the side of your pelvis

References:

Anterior vaginal wall repair. University of Maryland Medical Center | Home. Retrieved March 15, 2012, from
http://www.umm.edu/ency/article/003982.htm

Cystocele. - University of Maryland Medical Center | Home. Retrieved March 15, 2012, from
http://www.umm.edu/patiented/articles/000591.htm

Cystolene. National Institute of Health. Retrieved March 15, 2012, from http://kidney.niddk.nih.gov/kudiseases/pubs/cystocele

Reviewed March 15, 2012
by Michele Blacksberg RN
Edited by Jody Smith