Bladder Prolapse (Cystocele): Symptoms, Causes, and Treatment Methods

Bladder prolapse, known medically as cystocele, is the sagging or bulging of the bladder into the anterior (front) wall of the vagina. This condition develops as a result of the weakening of the muscles and connective tissues that support the pelvic floor. It is seen more frequently in women who have had vaginal deliveries, are in the post-menopause period, or have undergone pelvic surgery.

Grades of Cystocele

• Mild (Grade 1): The bladder sags slightly into the vagina.

• Moderate (Grade 2): The bladder descends to the vaginal opening.

• Severe (Grade 3): The bladder protrudes (bulges) out of the vaginal opening.

Causes

• Multiple or difficult vaginal births

• Estrogen deficiency after menopause

• Chronic constipation

• Obesity

• Heavy lifting

• Chronic cough

• Connective tissue weakness after pelvic surgery

Symptoms

• A feeling of fullness or pressure in the vagina

• Difficulty urinating

• Urinary incontinence (leaking) or frequent urination

• A sensation that the bladder is not emptying completely

• Discomfort during sexual intercourse

• Back and pelvic (groin) pain

Diagnostic Methods

• Gynecological examination

• Pelvic ultrasonography

• Urodynamic tests

• MRI (Magnetic Resonance Imaging), if necessary

Treatment Methods

1. Non-Surgical Methods

• Pelvic floor muscle exercises (Kegels)

• Use of a pessary

• Lifestyle modifications (weight control, avoiding heavy lifting)

2. Surgical Methods

• Anterior vaginal wall repair (Anterior Colporrhaphy)

• Augmentation (support) with mesh (in appropriate patients)

Preventive Methods for Cystocele

• Starting pelvic floor exercises postpartum (after childbirth)

• Keeping excess weight under control

• Treatment of constipation and chronic cough

• Performing regular exercise

Cystocele Treatment in Istanbul

As Assoc. Prof. Dr. Cengiz Andan, I offer detailed evaluations and personalized treatment plans for patients with cystocele complaints. It is possible to improve quality of life with both surgical and non-surgical options.

Frequently Asked Questions (FAQ)

Does a cystocele resolve on its own? No, but in the early stages, its progression can be slowed with exercises and supportive treatments.

Can a cystocele recur after surgery? The risk of recurrence is low with the appropriate surgical technique and preventive measures.

Is using a pessary safe in the long term? Yes, it can be used safely with regular medical check-ups.