- By sahlhealth
- May 18, 2021
- 20 views
Anterior Prolapse, also known as a cystocele (SIS-toe-seel), occurs when the supportive tissue between a woman’s bladder and vaginal wall weakens and stretches, allowing the bladder to bulge into the vagina. Anterior prolapse is also called a prolapsed bladder. Straining the muscles that support your pelvic organs may lead to anterior prolapse. Such straining occurs during vaginal childbirth or with chronic constipation, violent coughing or heavy lifting. Anterior prolapse also tends to cause problems after menopause, when estrogen levels decrease.For a mild or moderate anterior prolapse, nonsurgical treatment is often effective. In more severe cases, surgery may be necessary to keep the vagina and other pelvic organs in their proper positions.
-In mild cases of anterior prolapse, you may not notice any signs or symptoms. When signs and symptoms occur, they may include:
- A feeling of fullness or pressure in your pelvis and vagina
- Increased discomfort when you strain, cough, bear down or lift
- A feeling that you haven't completely emptied your bladder after urinating
- Repeated bladder infections
- Pain or urinary leakage during sexual intercourse
- In severe cases, a bulge of tissue that protrudes through your vaginal opening and may feel like sitting on an egg
-Signs and symptoms often are especially noticeable after standing for long periods of time and may go away when you lie down.
When to see a doctor
-A severely prolapsed bladder can be uncomfortable. It can make emptying your bladder difficult and may lead to bladder infections. Make an appointment with your doctor if you have any signs or symptoms that bother you.
-Treatment depends on how severe your anterior prolapse is and whether you have any related conditions, such as a uterus that slips into the vaginal canal (uterine prolapse).
Mild cases â€” those with few or no obvious symptoms â€” typically don't require treatment. You could opt for a wait-and-see approach, with occasional visits to your doctor to see if your prolapse is worsening, along with self-care measures, such as exercises that strengthen your pelvic floor muscles.
If self-care measures aren't effective, anterior prolapse treatment might involve:
- A supportive device (pessary). A vaginal pessary is a plastic or rubber ring inserted into your vagina to support the bladder. Your doctor or other care provider fits you for the device and shows you how to clean and reinsert it on your own. Many women use pessaries as a temporary alternative to surgery, and some use them when surgery is too risky.
- Estrogen therapy. Your doctor may recommend using estrogen â€” usually a vaginal cream, pill or ring â€” especially if you've already experienced menopause. This is because estrogen, which helps keep pelvic muscles strong, decreases after menopause.
When surgery is necessary
-If you have noticeable, uncomfortable symptoms, anterior prolapse may require surgery.
- How it's done. Often, the surgery is performed vaginally and involves lifting the prolapsed bladder back into place, removing extra tissue, and tightening the muscles and ligaments of the pelvic floor. Your doctor may use a special type of tissue graft to reinforce vaginal tissues and increase support if your vaginal tissues seem very thin.
- If you have a prolapsed uterus. For anterior prolapse associated with a prolapsed uterus, your doctor may recommend removing the uterus (hysterectomy) in addition to repairing the damaged pelvic floor muscles, ligaments and other tissues.
-If you're thinking about becoming pregnant, your doctor may recommend that you delay surgery until after you're done having children. Using a pessary may help relieve your symptoms in the meantime. The benefits of surgery can last for many years, but there's some risk of recurrence â€” which may mean another surgery at some point.
Dealing with incontinence
-If your anterior prolapse is accompanied by stress incontinence â€” involuntary loss of urine during strenuous activity â€” your doctor may recommend one of a number of procedures to support the urethra (urethral suspension) and ease your incontinence symptoms.