Cystocele Repair Treatment

Cystocele is a critical condition affecting the woman’s two organs, namely:

• bladder and
• vagina

The surgical correction of prolapse and restoration of bladder support is known as cystocele repair, anterior vaginal wall repair, or cystocele suspension. Treatment for this adverse condition depends on how severe the cystocele is and keeping away from certain activities or methods.

The surgical correction of prolapse and restoration of bladder support is known as cystocele repair or anterior vaginal wall repair. Treatment for this adverse condition depends on how severe the cystocele is and keeping away from certain activities or methods.

Types of Cystocele

Grade 1 (Mild): 

• Your bladder only goes a short distance into the vagina.

Grade 2 (Moderate): 

• Your bladder lowers into the vagina opening or somewhat outside of the vagina

Grade 3 (Severe): 

• Your bladder projects out of the vagina.

Causes of Cystocele

• An advanced age.
• Obesity or gain in weight.
• Childbearing.
• Lifting of heavy objects.
• Straining muscles during childbirth.
• Prolonged coughing.
• Constipation.
• Repeated straining during bowel movements.
• Former pelvic surgery.
• Feeble muscles around the vagina caused by lack of estrogen after menopause.
• A family history of cystoceles.

Symptoms of Cystocele

• Lower back pain.
• A feeling of heaviness in the pelvic while standing, lifting, or coughing gradually.
• Regular urinary tract infections.
• Leaking urine.
• Incomplete emptying of the bladder.
• Vaginal bulge in advanced cases that you can feel.
• Pain while doing sex.
• Difficulty in putting tampons or other vaginal pads.
• Loss of blood from the open skin.

Complications

• Kidney damage.
• Difficulty in emptying the bladder.
• Urinary tract infections.
• Stones in the bladder.

Diagnosis

Your healthcare expert will look into your medical history and take a physical and pelvic exam. The below mentioned tests can also be carried out:

Cystourethrogram (voiding cystogram): 

• While the woman is urinating, an X-ray of her bladder is taken, and contrast dye is injected into the bladder and urethra. It displays the bladder’s shape and any impediments. 

Urodynamics: 

• This is a test for bladder function. It indicates how much urine is present in the bladder before an urge to urinate. This reveals the cause of the leaking urine.

MRI: 

• This test is used to assess the severity of bladder prolapse.

Cystocele Repair Procedure

The exact nature of the surgery may vary, that will depend on how severe the prolapse is, the overall patient’s health, and the type of surgery. 

Below is the overview of different procedures.

1) Anterior Colporrhaphy:

Anesthetic: 

• To provide the patient’s maximum comfort throughout the surgery, general or regional anesthetic is given.

Incision: 

• To reach the weaker tissues and structures, a surgical incision is performed in the anterior vaginal wall.

Vaginal Wall Repair: 

• To return the bladder to its natural position, the anterior vaginal walls supporting tissues and fascia are strengthened and tightened.

Closure: 

• To secure the restored tissues, the incision is carefully closed with sutures.

2) Mesh Augmentation:

Anesthesia: 

•  This is given to make sure the patient is asleep and does not feel any pain or sensation during the surgery.

Mesh Placement: 

• A synthetic mesh is introduced through an incision in the anterior vaginal wall to offer extra support and reinforcement to the weaker tissues. The mesh serves as a scaffold, facilitating tissue growth and stability.

Securement and Closure: 

• The mesh is made secure by fastening, and the open wound is closed with sutures or surgical adhesive.

3) Minimally Invasive Techniques:

• Cystocele repair can be performed using minimally invasive techniques such as laparoscopic or robotic-assisted operations. These treatments imply accessing and repairing prolapsed tissues through small cuts and specialized devices. The procedure’s specific steps vary according to the strategy used.

As this is a same-day surgery, you can go home once the medical procedure is completed. Most people recover altogether within a few months.

What to do After the Surgery?

• You may need to spend one or two days in the hospital.
• You will have a catheter in place for a while after being released from the hospital.
• After two to six weeks, you will be able to urinate regularly.
• In nearly six weeks, you can get back to your regular activities.
• In fewer than six weeks, you might be able to start having sex again.
• You’ll be notified to
  • For at least the first three months, stay away from physically demanding tasks like lifting large weights and standing for extended periods of time.
  • Gradually increase your degree of activity.
  • When defecating, try not to strain.

Preventive Steps for Cystocele

A mild cystocele that is not causing you any trouble may not need any therapy. Besides this, other strenuous activities or heavy lifting that can exacerbate your minor cystocele may need further caution. 

Some options for treating minor cystocele include:

• A healthy weight for yourself.
• A diet that is rich in fiber and drinking plenty of water daily will avoid constipation issues. This is beneficial for the whole body.
• Kegel exercises that will beef up your vaginal, rectum, and urethral openings. Also avoid lifting heavy objects.
• An apparatus for the pessary that helps keep your bladder in place.