Anterior Prolapse (Cystocele)

Anterior Prolapse (Cystocele)

Overview of Anterior Prolapse or Cystocele

Anterior Prolapse is when the tissue that is between the bladder and vaginal wall, which means that the bladder bulges into the vagina. Anterior Prolapse may also be called a prolapsed bladder, fallen bladder, or cystocele. An anterior prolapse occurs when the muscles that aid the pelvic organs have been strained. The muscles become strained during vaginal childbirth or even during time of constipation, lifting, or coughing. When menopause occurs, the estrogen levels are decreased and problems are caused with the anterior prolapse. In most cases, surgery is not essential. In the severe cases, surgery may be recommended to keep all pelvic organs where they are supposed to be.

About the Pelvic Floor

The pelvic floor has a variety of muscles, connective tissues, and ligaments. When these work together, they support your bladder and the other pelvic organs, such as the bowel, uterus, and urine tube. These layers make a hammock from the tailbone to the pubic bone. It is avital to keep these muscles strong.

Symptoms of Anterior Prolapse or Cystocele

In mild to moderate cases of an anterior prolapsed, you may not notice any of the symptoms. You may experience pressure in your pelvis or vagina. The pressure may also feel like being full. You may also have severe discomfort when you are coughing, straining, bear down, or lift items. After urinating, you may feel like you have not emptied your bladder. Repeated bladder infections are often a sign of an anterior prolapse.

In more severe cases, a bulge of tissue may swell in the vaginal opening. This may be described as sitting on an egg. These symptoms are more noticeable after you have been standing for a long time. You will have relief from these symptoms when you lie down. If any of these symptoms are causing you severe discomfort, then it is time to make an appointment with your physician.

Causes of Anterior Prolapse or Cystocele

The pelvic floor can weaken over the time. Weakening can also be because of straining or childbirth. Some more specific cause of anterior prolapse are being overweight, straining when using the restroom, chronic cough, bronchitis, heavy lifting, and vaginal childbirth.

Risk Factors of Anterior Prolapse or Cystocele

Anterior Prolapse or Cystocele is only found in women. Women who have experienced anterior prolapse typically have experienced childbirth. The risk of anterior prolapse increase with age, especially after menopause. When your body stops producing estrogen, the pelvic floor is not as strong. When the uterus is removed, the pelvic floor also becomes weaker. Genetics also play a huge role in an anterior prolapse. Women who are overweight also are at a higher risk.

Prevention of an Anterior Prolapse or Cystocele

There are many self-care measures that you can take to decrease your chances of an anterior prolapse. Kegel exercises can help in strengthening the pelvic floor muscles, which is very important after having a baby. Since anterior prolapse happens when constipation occurs, it is important to eat high fiber foods to prevent constipation. When you are lifting, be sure to lift correctly with your legs and not your back or waist. Be sure to get to your ideal weight as soon as possible and ask your physician for advice and help with losing weight and stay at your ideal weight.

How To Perform Kegel Exercises

To begin, you will want to tighten your pelvic floor muscles. When contracting, or tightening these muscles, you will feel like these are the muscles that you will use to stop urinating. After this, you will want to hold this contraction for as long as you feel comfortable, for between two to ten seconds. The goal is ten seconds. Do three sets of ten repetitions daily. After you have been doing these, be sure to ask your physician if you are doing these correctly and if they are helping you. These exercises can be done at any time and at any location. These exercises are best when taught by a physical therapist or your physician.

Diagnosis of Anterior Prolapse or Cystocele

There are a few different ways to properly diagnose an anterior prolapse. Your physician may first begin with a pelvic exam. A pelvic exam occurs when you are laying down or when you are standing up. During this exam, they are looking for the tissue that is bulging into your vagina. When the tissue is bulging into your vagina, this is a sign of the anterior prolapse. Your physician will ask you to strain as if you were going to do a bowel movement. You will also be asked to contract as if you were going to stop the urine stream.

You will also be asked to fill out a form at your physician’s office which will allow your physician to see the degree of the prolapse and how much you are affected. Additional information can be gathered during the examination.

If your physician thinks that you have a significant prolapse, then your physician will ask to perform a bladder and urine test. You will be tested to see how well your bladder will empty. The urine test will look to see if there are any signs of bladder infection.

Treatment of Anterior Prolapse or Cystocele

Treatment all will depend on the severity of the anterior prolapse and if you have any other related conditions. Mild cases typically do not require a lot of treatment. In most cases, people will wait to see if they need treatment, depending on if your prolapse is getting worse. Self-care measures can help to strengthen your pelvic floor muscles. If self-care measures are not working, then there are many other treatments.

The first treatment is a pelvic device, also called pessary, is a plastic rubber ring that is inserted into your vagina to help the bladder. Your physician will help to fit the device and how to clean and reinsert them. Most people will choose this treatment because it is a temporary fix or because people believe the surgery is too risky.

Estrogen therapy will help to keep the pelvic muscles strong. This is typically applied through a vaginal cream, ring, or pill. This is used after a woman has already experienced menopause.

Surgery can also be necessary if someone has uncomfortable symptoms. The surgery is performed vaginally. It will help to place the bladder back into its right place, remove extra tissues, and will also tighten all of the muscles and ligaments. In some cases, a tissue graft will aid in reinforcing the vaginal tissues and increase the support of these tissues as well. If your uterus is prolapsed, your physician may recommend removing the uterus all together. When considering surgery, you may want to wait until after you are done having children. There is a risk of recurrence after the surgery.

What Can You Do with Anterior Prolapse or Cystocele

There many things that you can do to help your symptoms and also to get ready for your appointment with your physician. A Kegel exercise can help to strengthen your pelvic floor muscles. Speak with your physician if you are doing these exercises correctly and if you think they are helpful for you.

When you are preparing for your appointment, you can write down your symptoms and for how long you have had them. It is important to also write down any questions that you have, because you will want to remember to ask everything while you are there. In your notebook, also write down any medical information that your physician will want to know. This can also include any medication that you have.

It is important to also find a friend or relative to attend your appointments with you. This person can be there to help you remember any information. It is also important that you have support when making decisions.

Stress Incontinence

Urinary stress incontinence can occur during activities, such as exercising, sneezing, or coughing. This is when a small amount of urine leaks from the urethra. A variety of things can contribute to stress incontinence. Chronic coughing, obesity, or smoking can lead to stress incontinence. If you’re dealing with stress incontinence with your anterior prolapse, your physician will recommend a couple of procedures, such as urethral suspension, which will help to ease your incontinence.

Summary of Anterior Prolapse or Cystocele

An anterior prolapse or cystocele is found in women that typically have gone through menopause or have gone through childbirth. An anterior prolapse occurs when the supportive tissues in the pelvic floor are weakened. There are many ways to diagnose this problem, such as a test or a physical exam. Your physician will work to treat your symptoms. Treatment can be done through home exercises or through surgery, depending on the severity of your symptoms. Be sure to avoid weight gain or constant straining. Be sure to write down questions that you have for your physicians before the appointment. Find a friend that you can talk to about this condition so you have support.

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To request an appointment with Urology, call 251-343-9090. To request an appointment with Radiation Oncology, call 251-414-5665.

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