What is Cystocele? Symptoms, Causes and Treatment Methods

Cystocele is a disorder that occurs when the bladder sags towards the vaginal wall. It is also commonly known as "bladder prolapse" and occurs as a result of weakening of the pelvic floor muscles. The pelvic floor consists of muscles that support the uterus, bladder and intestines. Childbirth, aging, menopause and excess weight can cause these muscles to weaken. The bladder sliding towards the vagina can cause the bladder to not be supported enough, which can lead to urinary incontinence, discomfort and sexual problems in women.


 

What is Cystocele?

Cystocele is the condition in which the bladder sags towards the vagina and usually occurs as a result of the weakening of the pelvic floor muscles. These muscles normally support the bladder, but when this support weakens due to birth, aging or other factors, the bladder slides down and sags into the vagina. Cystocele can occur in different degrees and treatment options are determined according to the severity of the sagging.

Cystocele Stages:

• Stage 1: Mild cystocele. The bladder slightly sags into the vagina, but no significant discomfort is felt.
• Stage 2: The bladder sags to the vaginal opening, more pressure and discomfort are felt.
• Stage 3: The bladder can sag to the outside of the vagina, this is called advanced cystocele and usually requires surgical intervention.

These stages determine the severity of cystocele and play an important role in choosing the appropriate treatment method.

What Causes Cystocele?

The main cause of cystocele is the weakening or damage of the pelvic floor muscles that support the bladder and other pelvic organs. Pelvic floor muscle weakness can be caused by various reasons.

Main Causes of Cystocele:

• Birth: Especially vaginal birth can create great pressure on the pelvic muscles and cause them to weaken.
• Menopause: The decrease in estrogen levels during menopause can lead to weakening of the pelvic tissues and the formation of cystocele.
• Aging: With aging, the pelvic floor muscles lose their elasticity, which can cause the bladder to sag.
• Heavy Lifting: Weight lifting or heavy physical activities can put pressure on the muscles in the pelvic area. can increase the risk of cystocele by putting excessive pressure.
• Obesity: Excess weight can put extra pressure on the pelvic floor muscles and cause them to weaken.

These reasons are the main factors that increase the risk of cystocele. Therefore, it is important to keep the pelvic floor muscles strong to reduce the risk of cystocele.

What are the Symptoms of Cystocele?

The symptoms of cystocele can be mild or severe depending on the degree of prolapse. Some women may not notice the symptoms of a mild cystocele, but in advanced stages, serious discomfort may be experienced.

Main Symptoms of Cystocele:

• Pressure or Heaviness Feeling in the Bladder: A feeling of heaviness or pressure in the pelvic area is a common symptom.
• Urinary Incontinence (Stress Incontinence): Urinary incontinence may occur in situations such as coughing, sneezing or heavy lifting.
• Vaginal Discomfort: A feeling of fullness or a bulge may be noticed in the vaginal area.
• Inability to Empty Urine Completely: There may be a feeling that the bladder is not completely emptied and urge to urinate may develop.
• Discomfort During Sexual Intercourse: Discomfort and pain may be felt during sexual intercourse.

These symptoms may negatively affect daily life and require treatment depending on the progression of cystocele.

Cystocele Risk Factors

Cystocele may occur due to various risk factors. Being aware of these risk factors is important to reduce the risk of cystocele.

Factors That Increase Cystocele Risk:

• Age: As we age, the pelvic muscles weaken and the risk of bladder prolapse increases.
• Birth: Having multiple vaginal births can increase the risk of cystocele by weakening the pelvic floor muscles.
• Obesity: Being overweight can put extra pressure on the pelvic floor muscles, leading to the formation of a cystocele.
• Chronic Cough: Conditions that cause long-term coughing, such as asthma or bronchitis, can trigger cystocele by straining the pelvic muscles.
• Genetics: Women with a family history of pelvic floor weakness or cystocele may be at higher risk.

It is possible to prevent or delay the development of cystocele by paying attention to these risk factors.

Cystocele Treatment Methods

Cystocele treatment may vary depending on the severity of the prolapse and the symptoms experienced by the patient. While exercises and lifestyle changes may be sufficient in mild cases, surgical intervention may be required in more advanced cases.

Common Treatment Methods for Cystocele:

1. Kegel Exercises: These exercises strengthen the pelvic floor muscles and are very effective in mild cystocele cases.
2. Using a Pessary: The pessary device placed inside the vagina supports the bladder and relieves the effects of prolapse.
3. Laser Treatment: Non-surgical laser treatments can relieve bladder prolapse by tightening the pelvic tissues.
4. Surgical Interventions: Surgical intervention may be required in advanced stages. Surgery to support the bladder and pelvic organs corrects cystocele.

Treatment options are determined by the person's age, general health status, and degree of prolapse.

Ways to Prevent Cystocele

To prevent cystocele, it is important to strengthen the pelvic floor muscles and adopt healthy lifestyle habits.

Measures That Can Be Taken to Prevent Cystocele:

• Kegel Exercises: Kegel exercises should be done regularly to strengthen the pelvic floor muscles.
• Healthy Weight: Getting rid of excess weight reduces the pressure on the pelvic muscles and reduces the risk of cystocele.
• Avoid Heavy Lifting: Lifting weights puts pressure on the pelvic area. Avoiding heavy loads protects pelvic health.
• Bladder Training: Going to the toilet at regular intervals and not overfilling the bladder can protect bladder health.

These preventive measures can reduce the risk of cystocele and support pelvic floor health.

The Effect of Cystocele on Sexual Life

Cystocele can negatively affect sexual life. Some women may experience pain, discomfort or loss of self-confidence during sexual intercourse. These problems can be largely eliminated with treatment methods.

Effects on Sexual Life:

• Discomfort During Sexual Intercourse: Due to bladder prolapse, discomfort and pain may be felt during sexual intercourse.
• Sexual Self-Confidence: Vaginal fullness or protrusion due to cystocele may lead to decreased sexual self-confidence.
• Recovery After Treatment: With the applied treatment methods, the discomfort experienced during sexual intercourse decreases and self-confidence increases.

It is possible for sexual life to improve after treatment and satisfaction during sexual intercourse increases by eliminating these problems.

When is Cystocele Surgery Necessary?

Surgery may be required in advanced cystocele cases. Surgery allows the bladder to return to its normal position and the sagging is corrected using structures that strengthen the pelvic floor muscles.

Surgical Interventions:

• Bladder Support Surgery: These are surgeries performed to hold the bladder in place and strengthen the pelvic floor muscles.
• Pelvic Reconstruction Surgery: Surgical methods applied in advanced cystocele cases allow the bladder to return to its normal position.

Surgical intervention is preferred depending on the degree of sagging and its effect on the person's quality of life.

The Relationship Between Menopause and Cystocele

Menopause is an important risk factor for cystocele development. The decrease in estrogen hormone during menopause leads to weakening of pelvic tissues and increases the risk of cystocele.

Postmenopause Treatment Methods:

• Hormone Therapy: Estrogen supplements can strengthen pelvic muscles and relieve cystocele symptoms.
• Laser Therapy: Non-surgical laser treatments can be used to tighten vaginal tissues.
• Surgical Options:In advanced stages, surgical intervention may be required.

In postmenopausal cystocele cases, it is possible to relieve discomfort with appropriate treatment options.

Suitable Candidates for Cystocele

Cystocele treatment is suitable for women whose pelvic floor muscles have weakened and who have begun to experience bladder prolapse. Treatment options are evaluated based on the symptoms a person is experiencing and the degree of prolapse.

Who is Eligible for Treatment?

• Women with Weak Pelvic Muscles: Women with weakened pelvic floor muscles and symptoms of cystocele.
• Those with Urinary Incontinence: Women with urinary incontinence due to bladder prolapse.
• Those with Discomfort During Sexual Intercourse: Women with discomfort or pain during sexual intercourse.

It is important to talk to your doctor to find out if you are a candidate for treatment.

Persistence of Cystocele

The results obtained after cystocele treatment are usually permanent. However, factors such as aging and childbirth can cause the prolapse to recur over time. Exercises that strengthen the pelvic floor muscles can increase the permanence of the results after treatment.

Long-Term Effects After Treatment:

• Regular Exercise: Pelvic floor strengthening exercises such as Kegel exercises increase the permanence of the results after treatment.
• Healthy Lifestyle: Maintaining a healthy weight and avoiding heavy lifting reduces the risk of prolapse recurring.

Regular check-ups and healthy habits are important for the results to be permanent.

Frequently Asked Questions (FAQ)

1. How is cystocele understood?

Cystocele symptoms include a feeling of pressure in the pelvic area, urinary incontinence, a feeling of fullness in the vagina, and discomfort during sexual intercourse. If you have these symptoms, it is important to see a doctor.

2. Does cystocele go away on its own?

Cystocele usually does not go away on its own. Exercises and lifestyle changes can help in mild cases, but treatment is necessary in advanced cases.

3. Is it possible to prevent cystocele?

Yes, doing regular Kegel exercises, maintaining a healthy weight, and avoiding heavy lifting can reduce the risk of cystocele.

4. Does cystocele affect sexual life?

Yes, cystocele can cause discomfort and pain during sexual intercourse. These problems can be largely resolved after treatment.

5. Is cystocele surgery difficult?

The difficulty of the surgery depends on the degree of cystocele. While simple surgical procedures can be fast and effective, more extensive surgeries may be required in advanced cases.

6. Can cystocele recur?

There is a risk of cystocele recurring after treatment, but this risk can be reduced with regular exercise and a healthy lifestyle.