Female Cystocele: What it is and how it is treated

The article is written by the doctor Mr. Stavros Athanasiou.

Cystocele, also known as bladder prolapse or descent, is a condition where the bladder hangs into the vagina due to the inability of the pelvic floor muscles and tissues to support it.
 
This condition is more commonly found in women who have given birth vaginally. Its recognition is crucial for early diagnosis and effective treatment.

The causes of cystocele are varied and often coexist and combine. Below, we analyze in more detail the factors associated with the development of cystocele:

• Heredity: The genetic factor plays a significant role in the occurrence of cystocele. People with a family history of cystocele have a higher risk of developing the condition.
• Gender – Pregnancy – Childbirth: Women are more vulnerable to developing cystocele. This is related to childbirth as well as the weakening of the pelvic floor support tissues, which worsens with menopause.
• Increase in intra-abdominal pressure: Any condition that increases pressure in the abdominal area can contribute to the development of cystocele. This includes excessive exercise, coughing, smoking, and heavy lifting.
• Constipation: Cystocele can develop as a result of chronic constipation.
• Weight: Individuals with excess weight have an increased risk of developing cystocele, as the additional weight increases pressure on the pelvic floor.

You may have heard the term “3rd-degree cystocele” more often, as it is the type that requires immediate treatment and intervention. Cystocele is classified into degrees based on its severity:

• 1st degree (mild): The bladder slightly prolapses into the vagina but does not reach its opening.
• 2nd degree (moderate): The bladder prolapses lower and may reach near the vaginal opening, causing more pronounced symptoms.
• 3rd degree (severe): The bladder protrudes outside the vagina, causing significant discomfort and dysfunction.

The symptoms of cystocele can vary depending on the type and severity of the condition. Some people may not notice any symptoms, while others may experience discomfort or severe pain. Below are the main symptoms of cystocele:

• A feeling of pressure in the vagina
• Pain, frequent urination, urinary incontinence, or difficulty urinating
• A visible “bulge” at the vaginal entrance
• A sensation of heaviness in the vagina, especially after coughing or sneezing
• Recurring urinary tract infections or other urinary system infections
• Abdominal discomfort

It is important to note that cystocele symptoms may vary depending on the individual and the stage of the condition. In some cases, cystocele may be asymptomatic and discovered incidentally during a gynecological examination.

The treatment of cystocele typically requires surgery, but the approach can vary depending on the type and degree of cystocele.

• In cases of mild cystocele, it is recommended to avoid heavy lifting and to manage constipation in order to limit any initial symptoms, if they exist.
• In cases of moderate cystocele, and to avoid surgical methods, pelvic muscle strengthening through Kegel exercises is suggested, which may be more effective when using an EMS chair.
• As mentioned in other articles, vaginal pessaries are devices placed in the vagina to support the bladder and are used in cases where women do not wish or are not suitable for surgery for various reasons.
• In cases of severe cystocele (3rd-degree cystocele) or even moderate cystocele where conservative treatment has not yielded the expected results, cystocele is treated surgically. The goal of the surgery is to reposition the bladder to its normal position.

Exercises for cystocele aim to strengthen the pelvic floor muscles, which support the bladder, uterus, and rectum. The most well-known and effective exercise, as we have already mentioned for cases of female incontinence, is Kegel exercises, which involve alternating tightening and relaxing of the perineal and pelvic floor muscles to strengthen them. These exercises help improve bladder control, reduce the feeling of heaviness in the vagina, and prevent the worsening of cystocele. For them to be effective, it is important that they are performed correctly and regularly.

For better results, the exercises should be incorporated into daily life and performed consistently. In women with significant weakness in the pelvic muscles, the use of an EMS chair provides quicker and more effective strengthening. It is important to avoid intense exercises that increase intra-abdominal pressure, such as weightlifting or sudden abdominal exercises, as they may worsen the condition. Guidance from a physician specialized in pelvic floor health can help with the correct execution of exercises and adapting them to each individual’s needs. Systematic implementation of a pelvic floor muscle strengthening program can significantly improve the quality of life for women with cystocele, reducing symptoms and delaying the progression of the condition.

Cystocele is a common condition that affects a significant percentage of women. Its treatment, with specialized medical assessment, is easy and effective.

Address the problem of cystocele. Contact your doctor to guide you in the best possible way toward the most effective treatment for cystocele.