Cystocele (Fallen Bladder)

What is a cystocele?

Cystocele is the name for a hernia-like disorder in women that occurs when the wall between the bladder and the vagina weakens, causing the bladder to drop or sag into the vagina.

What are the results of a cystocele?

In addition to discomfort, the resulting dropped bladder can cause two kinds of problems to occur, including the following:

• urine leakage
• incomplete emptying of the bladder

The dropped bladder stretches the opening into the urethra, and urine may leak when a woman does any action that causes pressure on the bladder, such as coughing.

What are the grades of cystoceles?

What causes a cystocele?

A cystocele may result from the following:

• heavy lifting

• straining muscles during childbirth

• repeated straining during bowel movements

• menopause
  The hormone estrogen helps keep the muscles around the vagina strong, but, with menopause, the body stops making estrogen and the muscles around the vagina and bladder may become weakened.

How is a cystocele diagnosed?

In addition to a complete medical history and physical examination (which may reveal the fallen part of the bladder through the vagina), diagnostic procedures for a cystocele may include a cystourethrogram (also called a voiding cystogram). This is an x-ray of the bladder during urination and with the bladder and urethra filled with contrast medium to determine the shape of the bladder and any obstructions.

Other tests and procedures may be necessary to determine if there are any problems in the other areas of the urinary system.

Treatment for cystoceles:

Specific treatment for cystoceles will be determined by your physician based on:

• your age, overall health, and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment may include:

• activity modification (i.e., avoiding heavy lifting or straining that could cause the cystocele to worsen)

• pessary - a device placed in the vagina to hold the bladder in place.

• surgery (to move the bladder back into a more normal position)

• estrogen replacement therapy (may help to strengthen the muscles around the vagina and bladder)

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The specialist team at the Program for Abdominal and Pelvic Health includes, colorectal surgeons, gastroenterologists, gynecologists, physiatrists (rehabilitative and physical medicine specialists), physical therapists, psychologists, radiologists, urogynecologists and urologists. These teams work closely together in a coordinated effort to provide the outstanding care that is the hallmark of Rush.

At Rush University Medical Center in Chicago, our team is on the leading edge of advances in medicine, whether it’s a new minimally invasive technique or a novel drug. Because Rush is an academic medical center, our patients benefit from all of the latest innovations, including some that are unavailable anywhere else in the world.

For more information about the Program for Abdominal and Pelvic Health at Rush visit their Web site at www.rush.edu/paph.

Or phone the Program for Abdominal and Pelvic Health at (312) 942-7274.

Our program manager will guide patients through the program and discuss the patients' symptoms with them to determine the appropriate specialists for each patient.

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