What is Anterior Vaginal Prolapse (Cystocele)?

Anterior vaginal prolapse, also called cystocele or a prolapsed bladder, happens when the bladder moves down from its normal position in the pelvis and pushes against the wall of the vagina.

The pelvic organs, including the bladder, uterus, and intestines, are typically supported by the muscles and connective tissues of the pelvic floor. Anterior prolapse occurs either when the pelvic floor becomes weak or when excessive pressure is exerted on the pelvic floor. It can occur over time, during vaginal childbirth, or due to chronic constipation, violent coughing, or heavy lifting.

Anterior prolapse is curable: Nonsurgical treatment is often sufficient in cases of mild or moderate prolapse. However, for severe instances, surgical intervention may be necessary to reposition the vagina and other pelvic organs correctly.

What are the Symptoms for Anterior vaginal prolapse (cystocele)?

In mild cases of anterior prolapse, you might not experience any symptoms or signs. When they may appear, it includes:

• You may feel a sense of fullness or pressure in your pelvic area and vagina. Sometimes, you might see or feel a bulge of tissue in your vagina.
• You may also notice increased pelvic pressure when you cough, strain, lift, or bear down.

Additionally, you might have problems urinating. This includes difficulty starting your urine stream, feeling like you haven't emptied your bladder after urinating, a frequent urge to urinate, or leaking urine (urinary incontinence).

What Causes Anterior vaginal prolapse (cystocele)?

Your pelvic floor includes muscles, ligaments, and tissues that support your bladder and pelvic organs. Over time, these connections can weaken. This may happen due to childbirth or constant straining. When this occurs, your bladder can drop down and bulge into your vagina, a condition known as anterior prolapse.

Stress in the pelvic floor can be caused by:

• Pregnancy and vaginal childbirth
• Being overweight or obese
• Lifting heavy weights repeatedly
• Straining during bowel movements
• A long-term cough or bronchitis

What is the Diagnosis for Anterior vaginal prolapse (cystocele)?

To diagnose anterior, prolapse, your healthcare provider may do the following:

• Pelvic Exam: You will be examined while lying down and possibly while standing. The provider will look for a tissue bulge in your vagina that suggests pelvic organ prolapse. You might be asked to bear down, as if having a bowel movement, to check how this affects the prolapse. To assess the strength of your pelvic floor muscles, you will be instructed to engage them, similar to the action of trying to stop urine flow.
• Questionnaire: In most cases, your doctor might want to use a questionnaire to fill in the information related to your medical history, severity, and its effects on the quality of your life. These questions guide treatment.
• Bladder and Urine Tests: When prolapse is serious, doctors will take urine and check how your bladder is emptying. They might also test a urine sample to look for signs of a bladder infection, especially if you seem to be holding more urine than usual after you urinate.

How to treat anterior vaginal prolapse (cystocele)?

Treatment depends on symptoms, the level of severity associated with your case of anterior prolapse, or if you already have related complications, such as urinary incontinence or over one type of pelvic organ prolapse. Mild cases tend to require very little or nothing at all since such cases usually only have a few apparent symptoms. Most providers would give you a waiting game with constant visits to you prolapse site.

If you are experiencing symptoms of anterior prolapse, the first line of treatment options includes:

• Pelvic floor muscle exercises: Also known as Kegel exercises, these helps strengthen your pelvic floor muscles so that they can more effectively support your bladder and other pelvic organs. Your healthcare provider or a physical therapist can teach you how to do these exercises and help you ensure that you are doing them correctly.
• Kegel exercises: Kegel exercises may be most effective in reducing symptoms when the exercises are administered by a physical therapist and augmented with biofeedback. Biofeedback refers to the use of monitoring devices that help you tighten the appropriate muscles with maximal intensity and for the optimal duration of time. These exercises can help with your symptoms, but they won't reduce the size of the prolapse.
• Vaginal Pessary: A vaginal pessary is a device made of plastic or rubber that is inserted into the vagina to support the bladder. It doesn't cure the prolapse but can relieve symptoms by providing extra support. Your doctor will fit you for the pessary and teach you how to clean and reinsert yourself. Many women use pessaries as a temporary solution to avoid surgery, and some use them when surgery is too risky.

When is surgery necessary?

If you still have noticeable and uncomfortable symptoms after trying other treatments, you may need surgery to fix the prolapse.

• How it's done: Often, this surgery is accomplished vaginally, whereby the prolapsed bladder is positioned back in position using stitches or removal of loose vaginal tissue on the excess surface. Your gynaecologist would use a sort of tissue graft to reinforce vagina tissues and further enhance support by using it where your vaginal tissue appears very slim.
• Suppose you have a prolapsed uterus: Suppose you have a prolapsed uterus along with an anterior prolapse. In that case, your doctor may suggest removing the uterus (hysterectomy) and repairing the pelvic floor muscles, ligaments, and other tissues that are damaged.
• If you have incontinence: When an anterior prolapse is also accompanied by stress incontinence — leaking when you are running, lifting something heavy, or sneezing and coughing your doctor may advise one of several procedures to support the urethra (urethral suspension) and alleviate incontinence.

If you are pregnant or planning to become pregnant, you may have to wait until after you have finished having children to have surgery. Pelvic floor exercises or a pessary can help alleviate your symptoms until then. Surgery can provide benefits for many years, but there is some risk that prolapse will sometimes require additional surgery.

What are the Risk factors for Anterior vaginal prolapse (cystocele)?

These factors can increase your risk of anterior prolapse:

• Pregnancy and childbirth: Women who have given birth vaginally or with instruments, have had multiple pregnancies, or whose babies weighed a lot at birth are at a higher risk.
• Aging: Your risk increases as you age, especially after menopause when your body makes less estrogen. Estrogen helps keep the pelvic floor strong.
• Hysterectomy: Removing the uterus can sometimes weaken the pelvic floor, but this doesn't happen for everyone.
• Genetics: Some women inherit weaker connective tissues, making them more likely to develop anterior prolapse.
• Obesity: Overweight or obese women are more likely to have anterior prolapse.

Why choose Tender Palm Super-Speciality for Anterior vaginal prolapse (cystocele) treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Anterior vaginal prolapse (Cystocele) treatment in Lucknow, India, at an affordable cost. We have a team of experienced gynecologists and pelvic floor specialists, known as some of the best doctors for women’s health care. We provide accurate diagnosis, personalized medical management, pelvic floor therapy, and surgical treatment when required. Our Gynecology team has decades of experience in successfully treating Anterior vaginal prolapse (Cystocele) in Lucknow, India.

To seek an Expert Consultation for Bladder Prolapse treatment in Lucknow, India:

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