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Questions on Cystocele Treatment

A cystocele occurs when the wall between the bladder and the vagina is ripped or torn during childbirth. The result is the herniation of the bladder into the vagina. This usually causes pain, discomfort and trouble during urination. While the elastic tissues of the vagina will maintain the hernia for some time, over time, the elasticity will wear thin resulting in the need for surgery. To learn more about cystocele and the treatment for this condition, take a look below at the questions that have been answered by the Experts.

Is there any way to avoid surgery for a person who has grade 2-3 cystocele?

Case details: Grade 1 uterine descent, grade 2 low rectocele. Many women use Kegel and pelvic floor exercises to help this condition but these have their limitations. Using a pessary ring would be an option to consider as opposed to surgery. There are some pessary rings that cater to cystocele rather than uterine prolapse. However, when deciding to use a pessary ring, it is important to find an OB/GYN who is knowledgeable about the insertion and fitting of the ring. While there are several benefits to using this, one of the disadvantages of a pessary ring is the maintenance involved. For example, the use of vaginal creams and continuous check-ups are essential for women who use a ring. For those women who lead a very active lifestyle but choose not to have surgery, they may find that the cystocele will continue to drop over time. Using estrogen as a hormone replacement or a vaginal cream can help restore elasticity and strengthen the pelvic ligaments. However, the choice to have the surgery or not is always up to the patient and if she changes her mind later on, the surgery can still be an option.

Could pain, bleeding and bowel movement issues be due to recent cystocele repair?

Case details: Also had rectocele and removal of cervical stump. During the healing period after cystocele repair, it is important to ensure that the person’s bowel movements remain soft. Hard or firm stools can usually cause bleeding. Sometimes, this can also make a person hold off having a bowel movement. Doing this is not helpful for it will only increase the chance of a firmer/harder stool. One of the best ways to prevent hard stools is by taking colace (stool softener) twice a day. Adding more fiber to the person's diet also helps. At this stage, water intake is very important in helping the person pass softer stools as well. Typically, the person would also want to avoid any caffeinated drinks because caffeine can cause dehydration if consumed in large amounts. The normal amount of water to be consumed for an adult is at least 64 oz daily. If the person must have caffeinated drinks, a cup of water should be added to each cup of caffeine consumed. In other words, if the person has a cup of coffee, they will need to drink a cup of water as well. If the person is exercising, they should drink at least 20 oz of water for every 30 minutes of exercise. Furthermore, they should try to avoid caffeinated products during exercise.

What is a cystocele exactly and does it get worse over time? Will it require surgery?

A cystocele is the loosening of a woman's vagina and bladder and can eventually cause stress incontinence (urine leakage). While pelvic floor exercises and Kegel exercises help to an extent, many people prefer surgery to correct the issue. Also, if a woman has the surgical procedure before menopause, the healing process is generally faster. At his stage, it is better to consult with an OB/GYN and get a few exams done to understand what kind of surgery is needed. In most cases, the procedure will be performed by an urogynecologist or a urologist.

Is it normal to have leakage after a cystocele repair?

Leakage usually isn't common after a cystocele repair. This may be a sign of an over correction of the dropped bladder. In some cases, the over correction straightens the angle between the bladder and the urethra instead of leaving a more natural tilt. This may cause a leakage. If a woman is experiencing leakage after her cystocele repair, she should consult with her OB/GYN or the surgeon who performed the procedure. Many women develop a cystocele after having a baby and have to deal with the issue of a falling bladder or vaginal wall. While there are a few things that can be done to ease the symptoms of cystocele, very often, a surgical procedure helps the most. If you have questions or concerns about cystocele repair, ask an Expert for medical insights and suggestions on the best method of treatment based on your case history.
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