What is a cystocele?
A cystocele is a bulge on the front wall of the vagina. It occurs when the wall between bladder and vagina weakens and allows the bladder to droop into the vagina. Common symptoms of a cystocele may include a lump in the vagina and problems with emptying the bladder.
Diagnosis of a cystocele
Diagnosis is made on the basis of symptoms and vaginal examination in clinic. Other tests may be needed to find, or rule out, problems with the bladder.
Treatment of a cystocele
The choice of treatment depends on the nature and extent of the condition, as well as personal factors. Treatment options range from no treatment for a mild cystocele, to surgery for a more advanced symptomatic prolapse. If a cystocele is not bothersome, the patient may benefit from pelvic floor muscle training exercise to prevent its worsening.
Larger and bothersome cystoceles may require surgery to lift vaginal wall and the bladder in a more normal position.
Repair of an isolated cystocele, called anterior colporrhaphy, is performed through the vagina under local or general anaesthetic. In some women it may be more appropriate to repair cystocele laparoscopically, procedure called laparoscopic paravaginal repair. If there are other associated prolapse of the uterus (womb), it may be more appropriate to perform resuspension of the uterus (laparoscopic hysteropexy) in order to repair the prolapse.
Some women with a prolapse can be treated using a vaginal pessary instead of surgery. Not all women will be able to have satisfactory sexual intercourse when they have a ring pessary. Also, long-term pessary use can cause vaginal infection, discharge and bleeding, leading to discontinuation of its use.
Each patient will be able to discuss the available treatments with us in clinic, and can weigh the option of prolapse repair against the severity of her condition and other available treatments.