How is a cystocele treated?

If it is not bothersome, a mild cystocele may not require any treatment other than avoiding heavy lifting or straining that could cause the problem to get worse.

Other potential treatment options include the following:

  • Limiting fluids, especially drinks that contain caffeine, which are diuretics (increase the need to urinate).
  • Bladder training in order to lengthen the amount of time between bathroom visits.
  • Emptying the bladder on a regular schedule.
  • Weight loss.
  • Estrogen replacement therapy.
  • Kegel exercises to strengthen the openings of the urethra, vagina, and rectum. These exercises involve tightening the muscles that are used to stop the flow of urine, holding for 10 seconds, and then releasing.
  • If symptoms are modest , a device called a pessary may be placed in the vagina to hold the bladder in place. Pessaries are available in a number of shapes and sizes to ensure a proper fit. A pessary has to be removed and cleaned on a regular basis in order to avoid infection or ulcers.

What happens during and after surgery for a cystocele?

A serious cystocele may require reconstructive surgery called an anterior repair to move the bladder into a normal position. In this type of surgery, an incision (cut) is made in the wall of the vagina and the tissue that separates the bladder from the vagina is tightened. The surgeon might also implant permanent mesh grafts made of synthetic or biologic materials to improve vaginal support.

The patient usually goes home the day after the surgery. Complete recovery usually takes 4 to 6 weeks.

For women who never plan on having sexual intercourse again, surgeries that sew the vagina shut and shorten it so it no longer bulges are nearly 100% effective. These techniques are best done in elderly patients with multiple medical problems that would make reconstructive surgery a high risk.

What can be expected after treatment for a cystocele?

In mild cases, non-surgical treatments may be all that is needed to successfully deal with a cystocele.

When surgery is performed for more serious cases, some women will eventually need another surgery because the first surgery failed, or the cystocele returned, or another pelvic floor problem developed. In addition, the use of permanent meshes may cause complications, including urinary tract infections, exposure of mesh into the vagina, and pelvic or genital pain. Women who are older, who smoke, are diabetic, or who have had a hysterectomy, may be at higher risk for complications.

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