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Cystocele - Anterior prolapse

A cystocele occurs when the bladder droops down into the vagina. Depending on the grade of prolapse this can be from a grade one where the patient may not even be aware they have a cystocele, they may have stress incontinence symptoms or symptoms of not being able to empty the bladder. The other grades range from a bulge into the vaginal wall to the most severe where the bulge appears through the entrance of the vagina. A cystocele affects other organs such as the urethra as it is attached to the bladder.

 

As the bladder droops so the urethra can be displaced and may cause issues for emptying the bladder effectively.

You may find yourself needing to pass urine frequently or urgently (of both). Involuntary urinary leakage which may also be included during sexual activity is a typical symptom of a cystocele.  In the advanced stages of pelvic organ prolapse you may have difficulty urinating and incomplete bladder emptying.

 

Treatment
Always consult your physician if you are experiencing any of the above symptoms.
There are various treatments available which your physician may suggest. Never be afraid to ask questions.
Your physician may refer you to a gynaecologist, urologist or urogynaecologist, who are experts and specialize in these symptoms.

 

Avoid heavy lifting or straining that could cause the cystocele to worsen.

Depending on the grade of cystocele he may a pessary (you must be measured correctly for this), this is a medical device placed in the vagina to hold the bladder in place. Pessaries are available in a wide range of shapes and sizes.

 

Pessaries can be left in the body for a number of weeks which your doctor will advise on, to avoid infections or ulcers remove the pessary and clean on a regular basis.


It is recommended that medical grade silicone pessaries are used. There are a few pessaries which work better than others, but everyone is different and it's always advisable to discuss pessaries with your clinical practitioner.

Pelvic Angel offer professional pessary training courses. www.pelvicangel.com  

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IncoLite

IncoLite is 3.5cm wide and 5.5cm long and made from medical grade silicone in the United Kingdom.  It supports the bladder neck and urethra, controls stress incontinence and a mild anterior and posterior wall prolapse.

Bioteque ring with knob

Ring with knob

Rings with knobs come with or without a soft membrane. The knob is placed under the bladder neck. They come in various sizes ranging from 45mm diameter to 95mm diameter.

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Marland

The Marland pessary can be used for anterior and posterior wall prolapses. The high side supports the bladder neck and is available with or without a membrane