Cystocele

WHAT YOU SHOULD KNOW:

• A cystocele (SIS-to-sel) is a condition where a part of the bladder bulges out or protrudes into the vagina. It is commonly caused by weak muscles and ligaments (bands of tissue) that hold and support the bladder. This may be due to aging, previous surgery, too much straining, pregnancy, or vaginal trauma during childbirth. There are usually no signs and symptoms with a mild cystocele. In some cases, you may feel a soft bulge in your vagina that may or may not come out through the vaginal opening. You may also have difficulty passing urine, vaginal pain or bleeding, or a feeling of fullness in your abdomen.
  
  
• A bimanual exam may be able to determine if you have a cystocele. You may also need other tests, such as pelvic floor fluoroscopy, magnetic resonance imaging (MRI), or ultrasound. Treatment may include a high fiber diet and estrogen therapy. A pessary (ring-like device) or tampon (cotton plug) placed inside your vagina may help support your bladder. You may also need surgery to repair the weak or thin muscles around your vagina and bladder. With treatment, such as medicine, a pessary, or surgery, your symptoms may be relieved and your quality of life may be improved.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Treatment of a cystocele may cause unpleasant side effects. Estrogen therapy may increase your risk of having abnormal vaginal bleeding or possibly cancer. The use of a pessary may cause infection, discomfort, or it may fall out. There are also risks when having surgery, such as infection or bleeding. If a cystocele is not treated, you may continue to have pain during sex or while passing urine. If the cystocele pushes out of your vaginal opening, it becomes more difficult to treat and may cause serious medical problems. Ask your caregiver if you are worried or have questions about your condition, medicine, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

Tests:

You may need one or more of the following tests:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Imaging tests:
  
  
  • Cystourethrogram: A dye is injected and x-rays are taken while you pass urine. The dye makes an outline of your bladder and urethra (tube where urine passes). This shows the changes that occur in your urinary tract while urinating.
    
    
  • KUB x-ray: An x-ray machine takes pictures of your kidneys (K), ureters (U), and bladder (B). The ureters are tiny tubes that carry urine from your kidneys to your bladder. The bladder is where the urine is stored before leaving your body. Caregivers use these pictures to check for problems with your intestines , kidneys, or abdomen.
    
    
  • Magnetic resonance imaging: This test is also called an MRI. During an MRI, computerized pictures are taken of your abdomen or pelvis. Caregivers use these pictures to look for problems in your bladder, vagina, rectum, or other pelvic organs. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.
    
    
  • Pelvic floor fluoroscopy: Fluoroscopy is a special type of x-ray that shows the movement of your bladder, vagina, or bowels. Pictures of these body parts are taken and may be shown on a video screen. Caregivers may give different contrasts, such as a dye, so your body parts show up better.
    
    
  • Ultrasound: Sound waves are used to show pictures of the inside of your abdomen. A small handle with lotion on it is gently moved around your abdomen. The handle may also be placed in your vagina. Pictures of your bladder, vagina, rectum, or other organs are seen on a TV-like screen.
  
  
• Other tests:
  
  
  • Cystoscopy: A thin tube is inserted into your urethra and up into your bladder. Caregivers will look at the inside of your bladder for stones, bleeding, tumors, or signs of infection.
    
    
  • Urine test: A sample of your urine is collected and sent to a lab for tests.
    
    
  • Urodynamics: This test checks if the muscles of your bladder are working properly. It also measures how much urine your bladder can hold. This test can also tell whether your bladder fills and empties in a normal way.

Treatment options:

You may have one or more of the following:

• Estrogen therapy: If you are in menopause, caregivers may recommend estrogen hormones. This may be taken as a pill by mouth or applied as a cream in your vagina. Estrogen helps keep your pelvic muscles strong and may prevent your cystocele from getting worse.
  
  
• Pessary or tampon: A pessary is a plastic or rubber ring and a tampon is a plug of cotton or other absorbent material. These are placed inside the vagina to support the bulging tissues in your bladder and vagina.
  
  
• Surgery: For severe cases of cystocele, surgery may be needed to move the bladder back into place. The muscles and ligaments around your vagina may be sutured (tied up) to make them strong. A mesh patch may be placed to add support to the vaginal wall.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Cystocele (Inpatient Care)