What is a cystocele?

A cystocele is a condition in which the pelvic floor has weakened and the bladder drops into the vagina. This occurs when the muscles supporting the bladder have become stretched or weakened. This weakening is caused by increased abdominal pressure which in turn could be caused by the pregnancy and birthing process, heavy lifting, or a chronic cough. A cystocele can cause incontinence, a sense of vaginal pressure, and incomplete emptying of the bladder. A patient may experience frequent UTI’s and/or urinary frequency.

Evaluation

Evaluation will involve a complete physical exam and additional testing based on the presentation of symptoms. The complete evaluation would include imaging, usually in the form of an ultrasound, as well as a cystoscopy and urodynamic testing.

Treatment

Treatment will vary based on diagnosis, but can range from simple pelvic floor exercises to a complex pelvic repair. If a patient needs the bladder pushed up, but is not a surgical candidate, they can try a pessary which goes in the vagina to keep the bladder in position.

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