Cystocele: Causes, Symptoms, Treatment, and Cost

The medical disorder known as cystocele causes the bladder to extend into the vagina. This occurs when the muscles and tissues supporting the bladder weaken or stretch, allowing the bladder to drop down and push against the vaginal wall.

There are three types of cystocele:

• Grade 1 cystocele: The bladder bulges slightly into the vagina.
• Grade 2 cystocele: The bladder bulges to the opening of the vagina.
• Grade 3 cystocele: The bladder protrudes from the vaginal entrance.

There are many causes of cystocele.

• Weakened pelvic floor muscles brought on by pregnancy, old age, or surgery.
• Straining or coughing often when going potty.
• Being overweight or obese.
• Pelvic organ prolapse runs in families or is inherited.
• The menopausal hormone changes weaken the pelvic floor muscles.
• The pelvic floor muscles are strained during heavy lifting or physically demanding activities.
• Straining during bowel motions or urination may be caused by chronic constipation or urinary tract infections.
• It's crucial to remember that some women might have cystoceles for no apparent reason.

Some common symptoms of cystocele include:

• A lump or protrusion within the vagina.
• A sensation of weight or fullness in the pelvic region.
• Pain or discomfort in the lower back or pelvis.
• Urinary issues, such as the inability to fully empty the bladder or pee leakage (incontinence).
• Painful sex exchange (dyspareunia)
• Urinary tract infections that recur (UTIs)
• Difficulty going to the toilet (in severe cases)
• The feeling of needing to push or bear down during bowel movements or urination (in severe cases).
• It is important to note that not all women with cystocele will experience symptoms. The degree of pelvic organ prolapse might affect how severe the symptoms are.

There are various methods to prevent cystocele, including:

• Maintaining a healthy weight: Weight gain strains the pelvic muscles, which may result in conditions of the pelvic floor such as cystocele.
• Regular exercise: Strengthening the pelvic floor muscles through regular exercise can help prevent cystocele.
• Avoiding heavy lifting: Bending, twisting, or lifting heavy objects can increase the risk of developing cystocele.
• Quitting smoking: Smoking can weaken the pelvic floor muscles, leading to an increased risk of developing cystoceles.
• Practicing good toileting habits: Avoiding straining during bowel movements and urination can help prevent cystocele.
• Treating cough or constipation: Chronic cough and constipation can put pressure on the pelvic floor muscles, leading to an increased risk of developing cystocele.

hese tests may be performed to diagnose Cystocele:

• Pelvic examination: This allows the doctor to inspect the external genitalia and vagina for any noticeable lumps or bumps. It can also detect any changes in the shape or feel of the bladder or urethra that could indicate a cystocele.
• Ultrasound scanning: It allows visualization of the bladder and surrounding structures, as well as the visualizing of the movement of urine from the bladder.
• Cystography: A lower urinary tract X-ray is used to identify any abnormalities in anatomy or build-up of fluid indicating a cystocele.
• Urodynamic testing: This test looks at how well the bladder empties its contents during urination, which can help understand the underlying cause of a cystocele if one is found on imaging tests such as ultrasound scanning and cystography (X-ray).
• MRI scan: If an exact cause of a cystocele needs to be determined, MRI can provide detailed images in 3D that show better resolution than an ultrasound scan without exposing you to radiation risks associated with X-rays and CT scans.
• CT scan: If other diagnostic tests fail to give accurate results regarding a suspected cystocele, then your doctor may recommend using a CT scan instead so they can better visualize what’s happening within your pelvic floor area and get detailed images in 3D which may not be possible with other methods due to radiation risks involved with X-rays.

Cystocele may result in several issues, such as:

• Urinary incontinence: One of the potential complications of cystocele is urinary incontinence, where a person may experience involuntary leakage of urine.
• Urinary tract infections: Another complication is urinary tract infections, as the bladder may not be able to fully empty itself during urination, leading to a buildup of bacteria.
• Painful sexual intercourse: Cystocele may also cause discomfort or pain during sexual intercourse, as the bladder may push against the vaginal wall.
• Kidney damage: In severe cases, cystocele may lead to the formation of bladder stones or kidney damage due to urine buildup and retention.

Here are some natural Remedies for Cystocele:

• Ashwagandha: It supports the tissues and muscles of the pelvis.
• Chitrakadi Vati: It reduces inflammation and swelling in the pelvic area.
• Gokshura: It improves urine flow and strengthens bladder muscles.
• Shatavari: It balances hormonal levels and improves overall reproductive health.
• Triphala: It regulates bowel movements and prevents constipation, which can worsen Cystocele symptoms.

These are some foods to eat in Cystocele:

• Consuming high-fiber meals like whole grains, fruits, and vegetables may help avoid constipation, which can make the symptoms of cystocele worse.
• Lean proteins such as chicken, turkey, and fish can be included in the diet to support muscle health and repair.
• Probiotic-rich foods such as yogurt and kefir can help maintain a healthy gut microbiome and reduce the risk of urinary tract infections, which can be a complication of cystocele.
• Foods rich in vitamin C, such as citrus fruits and tomatoes, can help boost the immune system and promote healing.
• To keep hydrated and support urinary tract health, drink plenty of water. Alcohol and caffeine abstinence may both be good for your bladder.

Avoiding certain meals and drinks that may make cystocele symptoms worse includes avoiding:

• Caffeine: Caffeine acts as a diuretic, which increases the frequency of urination and can irritate the bladder. This can worsen the symptoms of cystocele.
• Alcohol: Also a diuretic, alcohol might make you urinate more often. It can also irritate the bladder and exacerbate the symptoms of cystocele. Spicy foods: Spicy meals might aggravate cystocele symptoms by irritating the bladder. It is best to avoid foods that contain chili peppers, hot sauce, or other spices.
• Acidic foods: Acidic foods like tomatoes, citrus fruits, and vinegar may irritate the bladder and make cystocele symptoms worse.
• Carbonated drinks: Sparkling water and other carbonated beverages might aggravate the bladder and make you urinate more often. If you have cystoceles, it is advised to stay away from these beverages.
• High-sugar foods: High-sugar foods, such as candy, cake, and other desserts, can increase the frequency of urination and worsen the symptoms of cystocele.

Treatment options for cystocele:

• Pelvic floor muscle exercises: The bladder may be supported and the severity of the cystocele can be lessened by strengthening the pelvic floor muscles. A physical therapist or urologist can teach appropriate exercises.
• Pessary: a support system for the bladder that is put into the vagina to keep it from protruding. They come in a variety of sizes and forms, and a medical specialist should fit you with one.
• Lifestyle changes: Avoiding heavy lifting, maintaining a healthy weight, and avoiding constipation can help reduce symptoms of cystocele. Anterior vaginal repair: This surgery involves using stitches to tighten the front wall of the vagina, which helps to support the bladder.
• Hysterectomy: If the uterus is contributing to the cystocele, it may be removed through a hysterectomy, which can also help to reduce the prolapse.
• Mesh surgery: In some cases, a surgical mesh may be used as a support to help keep the bladder in place.
• Sacrocolpopexy: This surgery involves using a mesh or other material to attach the top of the vagina to the sacrum (tailbone), which can help to support the pelvic organs.
• Colpocleisis: In some cases, particularly in older women who are not sexually active, a colpocleisis may be recommended. This surgery involves closing off the vagina partially or completely, which can help to support the bladder and other pelvic organs.

Patients should consult a gynecologist or gynecologist to diagnose and treat cystoceles. This type of specialist is trained to identify and address female pelvic floor disorders such as cystocele.

Medicines that can help with the symptoms of cystocele include:

• Anticholinergics: Drugs that reduce bladder spasms and urge incontinence.
• Estrogen therapy: Hormonal therapy that can help strengthen the pelvic muscles and prevent further prolapse.
• Muscle relaxants: Medications that can help ease pain and discomfort and reduce muscle spasms.
• Topical estrogen cream: Applied vaginally, this cream can help strengthen the vaginal tissues and reduce prolapse symptoms.
• Antibiotics: to treat urinary tract infections, which may make the symptoms of cystocele worse.
• Pain medications: To manage chronic pain that may accompany cystoceles.
• Anti-inflammatory drugs: To reduce inflammation and swelling that can contribute to prolapse.

The severity of the problem and the chosen course of therapy will determine how long it takes for the cystocele to heal. Mild cases can resolve on their own within a few weeks, while more severe cases may require surgery and may take several weeks to months to fully recover.

Depending on the particular instance and the surgical technique used, the outcomes of cystocele surgery might vary. Some patients may experience permanent improvement in their symptoms, while others may require additional treatment or experience a recurrence of symptoms over time.

Medicines that can help with the symptoms of cystocele include:

• Anticholinergics: Drugs that reduce bladder spasms and urge incontinence.
• Estrogen therapy: Hormonal therapy that can help strengthen the pelvic muscles and prevent further prolapse.
• Muscle relaxants: Medications that can help ease pain and discomfort and reduce muscle spasms.
• Topical estrogen cream: Applied vaginally, this cream can help strengthen the vaginal tissues and reduce prolapse symptoms.
• Antibiotics: to treat urinary tract infections, which may make the symptoms of cystocele worse.
• Pain medications: To manage chronic pain that may accompany cystoceles.
• Anti-inflammatory drugs: To reduce inflammation and swelling that can contribute to prolapse.

The cost of treating a cystocele in India depends on the type of treatment and the patient's overall health. Generally, a simple outpatient procedure like a pessary insertion can cost anywhere from ₹500 to ₹2,500 while more complex surgical procedures may cost anywhere from ₹25000 to as high as ₹3 lakhs. Medications and aftercare may add additional costs.

Depending on the kind of therapy used, the adverse effects of cystocele treatment might vary. Generally, the most common side effects experienced by patients include:

• Lower abdominal and pelvic area discomfort or pain.
• tissue irritation in the vagina.
• A rash or discoloration of the skin
• risk of urinary tract infections rising.
• Potential harm to adjacent organs like the uterus or bladder.

In rare cases, there may be an increased risk for perforation of nearby organs. Additionally, if a surgical approach is taken to correct cystocele, there may be risks associated with general anesthesia use.