Is your bladder prolapsed? (Cystocele) - Let's learn about the causes, symptoms and treatment in simple terms

Do you sometimes feel like something is coming out of your vagina, or do you constantly feel heavy or full in your lower abdomen? You may be embarrassed or afraid to talk about it. But you should know that this is a condition that affects many women and can be successfully treated. Today, we will talk about this condition called a prolapsed bladder, or in medical terms, a cystocele.

Simply put, what is a prolapsed bladder (Cystocele)?

Imagine, the organs inside our pelvic area, like the bladder and uterus, are held in place by a network of strong muscles and ligaments, much like a rocking chair is suspended by ropes.

However, due to various reasons like having children, aging, and lifting heavy weights, these muscles and ligaments can become weak and stretched. Then the bladder cannot stay in its usual position. Gradually, it starts to lower and fall into the vagina. That is why we call it a cystocele or a fallen bladder. This is a type of pelvic organ prolapse, a common condition in which the organs in the pelvic cavity fall down.

Are there different levels of this condition?

Yes, this condition is not the same for everyone. It is mainly divided into three levels (grades). This determines how severe the condition is and what treatment is needed.

Is Cystocele a serious, dangerous condition?

It depends on your level.

• In mild cases, you may feel a little discomfort. Or you may accidentally leak a little urine when you cough, laugh, or lift something. This is also called ``urinary incontinence.''
• If it is severe , it can be a bit more serious. Because the bladder is lowered, the urethra is blocked, and you may not be able to urinate properly. This can lead to urine retention, which can lead to infections and, over time, damage to the kidneys.

What are the common symptoms of this condition?

See if you have one or more of these symptoms:

• Feeling or actually seeing something like a ball coming out of the vagina .
• A feeling of fullness, heaviness, or pain in the pelvic area. This discomfort may worsen, especially when standing, lifting, coughing, or as the day progresses.
• Needing to urinate more often than usual.
• A feeling that the bladder has not been completely emptied when urinating.
• Frequent occurrence of urinary tract infections (UTIs) .
• Difficulty inserting items such as tampons used during menopause into the vagina.

Why is this happening? What are the main reasons for this?

There are several main reasons why the muscles of the pelvic floor become weak.

• Vaginal births: When you have a baby, there is a lot of pressure on the pelvic muscles, which can cause them to become stretched or weak.
• Family history: If your mother or sister had this condition, you are at higher risk of developing it too.
• Obesity: When you are overweight, meaning your Body Mass Index (BMI) is over 30, there is always extra pressure on the pelvic muscles.
• Hysterectomy: Sometimes the supporting tissue can become weak after this surgery.
• Decreased estrogen levels: As you age, especially during menopause, your body's estrogen levels decrease. This hormone helps keep the muscles around your vagina strong. When it decreases, muscle weakness can accelerate.
• Frequent heavy lifting and chronic cough: This risk is also higher for those who work in jobs that require frequent lifting or who have a long-term cough due to diseases such as asthma or bronchitis.

How does a doctor diagnose this?

If you have these symptoms, you should see a gynecologist or a urologist.

The doctor will ask you about your symptoms, perform a physical examination, and, if necessary, may order additional tests to confirm the condition.

• Urodynamic testing: This measures your bladder's ability to hold and release urine.
• Cystoscopy: In this, a thin, pencil-like tube with a camera attached (cystoscope) is inserted through the urethra to examine the inside of the bladder.

What are the treatments for this?

Treatment options depend on the severity of your condition, your age, and how much your symptoms affect your daily life.

Treatment for a mild condition

• Lifestyle changes: Avoiding heavy lifting, controlling body weight, and preventing constipation (eating a high-fiber diet and drinking plenty of water) can help prevent the condition from getting worse.
• Kegel exercises: This is the most important and simplest treatment. Ask your doctor or physical therapist how to properly do these exercises to strengthen your pelvic muscles.
• Pessary: ​​This is a small device made of rubber or silicone that is placed inside the vagina. It lifts the bladder and helps hold it in place.
• Estrogen replacement therapy: This treatment can be given to strengthen muscles for those who have low estrogen levels after menopause.

Treatment for moderate/severe conditions

Surgery may be required for severe cystoceles that cannot be controlled with other treatments.

Anterior colporrhaphy is a common surgery for this. In this procedure, the surgeon moves the prolapsed bladder back into place and strengthens the weakened muscles and tissues that hold it in place. You can usually go home the same day after this surgery, and you can recover fully in a few months.

When should I see a doctor?

If you have symptoms of a cystocele, especially if they interfere with your daily activities, see a doctor immediately . Don't be embarrassed or afraid. This is a very common condition.

Bladder prolapse, cystocele, pelvic organ prolapse, women's health, gynecology, bladder diseases, Kegel exercises