Cystocele Information
Definition
A cystocele is a bulging or "dropping" of the bladder towards the vagina. This occurs when the wall between a woman's bladder and her vagina weakens and allows the bladder to droop into the vagina. Due to gravity and other forces like straining, pushing, lifting, etc, the bladder bulges through these weak areas towards the vagina. The skin of the vagina i.e. the part of the vagina that you can see or feel, is easily stretched, which is why a bulge of the bladder can become visible.
Symptoms
It is possible to have a cystocele that doesn't actually cause any discomfort or symptoms. Sometimes a physician or nurse will notice a "relaxation" or mild cystocele that hasn't actually bothered the patient. Those types of cystoceles don't necessarily require treatment. When a cystocele exhibits symptoms, some typical complaints include "I have a heavy/ bulging or falling sensation" or "It feels like my insides are falling out" or "There's something in the way when I try to have intercourse" or "I can no longer hold a tampon inside". With a moderate cystocele, the bulge is significant, but it hasn't yet protruded beyond the opening of the vagina. A woman with this degree of prolapse may or may not have bothersome symptoms such as a heavy bulging or pressure sensation. With cases of severe cystocele, there will be a bulging well beyond the opening of the vagina. Women with this degree of prolapse usually have very bothersome symptoms. Sometimes the cystocele will actually bulge down far enough to "kink" the urethra (the tube where urine leaves the bladder), which may cause discomfort and problems with emptying the bladder... When that happens, a woman may actually need to push on the cystocele with her fingers to straighten out the kink and allow urination to occur. On occasion, the effect on the uretha of the fallen bladder is to stretch it open, which can cause urine to leak, especially when a woman sneezes, coughs or laughs, or if her movement applies pressure to her bladder. The protrusion of the bladder into the vagina may also create a pool of stale urine in the bladder, which cannot be easily emptied, and as a result it can become a breeding ground for bacteria. This can result in Cystitis (an inflammation of the bladder), signalled by painful and difficult urination.
Causes
Straining is a usual suspect where a cystocele is concerned, and of course one of the most obvious instances of straining for a woman is during child birth. Other causes include the lifting of heavy items or straining during bowel movements. The estrogen hormone helps to keep strong muscles around the vagina. When women go through menopause (when they stop having periods), their bodies stop making estrogen, so the muscles around the vagina and bladder may grow weak.