Cystocele

Best Urology Hospitals Bangalore | Nelivigi Multispeciality provides the Best Cystocele Treatment in Bangalore with the Best Urologists in Bangalore. Checkout symptoms, signs, and treatment details now.

This is a condition where there is a protrusion of the urinary bladder through the vagina. In medical parlance, it is prolapse of the urinary bladder.

Symptoms

The patient is usually an elderly female. The usual complaint is a feeling that ‘something comes out of the vagina’. What she feels is the urinary bladder protruding through the vagina. This indicates that a large portion of the bladder is coming out. However, there are lesser degrees of protrusion also wherein the patient has difficulty in passing urine and a feeling that some urine remains inside even after urination. Many patients also say they have to strain to pass urine and have a poor urine flow. Some may have repeated urinary tract infections.

Evaluation and tests

When the patient goes to the doctor for these symptoms, the doctor carries out a detailed evaluation which includes a questionnaire and a physical examination. In case he wants extra information, he will order an ultrasound examination or MRI in rare cases. With these, he can make the correct diagnosis and discuss the treatment options with the patient.

Why does it happen?                                                

A cystocele occurs when the muscles supporting the organs of the pelvis like a vagina, uterus bladder, etc. are weak. As a consequence, these organs prolapse out and cause various problems. This typically happens in old age due to overall atrophy and weakness of the muscles. It is even more common when they have had multiple childbirths.

Treatment

The treatment depends upon many factors like the severity of prolapse, the general condition of the patient, and of course the desires of the patient. In the case of mild cystocele, no specific treatment is offered. They are treated only for the symptoms.

However, in case the prolapse is complete then surgical treatment is the preferred option. In case the patient is not fit to undergo surgery or if she is not interested in surgery then a pessary is offered as a treatment.

What is a pessary?

A vaginal pessary is a ring made of plastic which is inserted in the vagina and acts as a support to the prolapsed bladder. This can be self-inserted by the patient and removed whenever she wants. This can be used either as a temporary treatment or can be a permanent measure.

Surgeries for cystocele

The definitive treatment for large and completely prolapsing cystoceles is surgery. The surgery can be performed either through the vaginal route or through the abdomen. The vaginal repair consists of pushing back the bladder, strengthening the pelvic floor by stitches and mesh. The use of mesh has decreased now because of mesh-related complications. Therefore more and more surgeons are preferring abdominal surgery to repair cystocele. Here keyhole surgery is done to fix the urinary bladder to the part of the backbone called the sacrum. This provides lasting relief with very little pain.

Outcomes

The abdominal surgery offers a better outcome than vaginal surgery but still, recurrences are seen. This is because of the overall weakness of the muscles which are only partly compensated by surgery. Therefore the patient is advised not to lift heavy weights after the surgery. She also should keep her weight under control if she is overweight.

Overall, the results are satisfactory if some lifestyle modifications are followed.

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