A cystocele is when there is a weakening of the muscles that support the bladder, causing the bladder to dislocate, which can exit through the vagina and cause symptoms such as a feeling of incomplete emptying of the bladder, urinary incontinence, lower back pain, a feeling of heaviness in the bladder and appearance of a lump in the bladder that can be identified during vaginal examination.
Cystocele, also called low bladder, is more common after the age of 50, and can be favored by excess weight, multiple pregnancies, chronic cough, constipation and lifting a lot of weight, for example.
It is important to consult a gynecologist as soon as the first symptoms of cystocele are noticed, as this way the doctor can evaluate the symptoms, confirm the diagnosis and recommend the best treatment, which may vary according to the severity, and the use of medications may be indicated, pelvic exercises, pessary placement and surgery.
Main symptoms
The main symptoms of cystocele are:
- Sensation of incomplete emptying of the bladder;
- Pain and sensation of pressure in the lower part of the belly;
- Feeling of heaviness in the bladder;
- Urgent urge to urinate;
- Pain during sexual intercourse;
- Urinary incontinence;
- Dor in the lumbar;
- Lump in the vagina, which can be felt when performing vaginal examination.
Additionally, cystocele can make it difficult to put on tampons, increased frequency of urinary tract infections, and increased pressure in the pelvic area when coughing, lifting, or carrying weight.
How the diagnosis is made
The diagnosis of cystocele must be made by the gynecologist initially by evaluating the signs and symptoms presented by the woman. To confirm the diagnosis, the doctor may recommend magnetic resonance imaging, cystourethroscopy and urodynamic studies.
Consult your nearest gynecologist to assess the risk of cystocele and thus initiate the most appropriate treatment, if necessary:
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Cystocele graus
According to the characteristics and symptoms, cystocele can be classified into grades:
- Grade 1: mild cystocele, in which there is only a small drop of the bladder into the vagina, with no symptoms being noticed;
- Grade 2: moderate cystocele, in which the bladder falls to the opening of the vagina;
- Grau 3: cistocele grave, which happens when the bladder leaves the vagina;
- Grade 4: very severe cystocele, in which the bladder comes out completely through the vagina, and is considered a medical emergency.
It is important that the degree of the cystocele is defined by the doctor so that the most appropriate treatment for the case can be recommended.
Causes of cystocele
Cystocele occurs due to the weakening of the pelvic floor muscles that support the bladder, which can be favored by some factors, such as:
- Overweight;
- Chronic constipation;
- Lifting a lot of weight;
- Excessive physical activity;
- Normal delivery;
- Previous pelvic surgery;
- Multiple pregnancies;
- Chronic cough;
- Hormonal changes, especially during menopause.
Cystocele is also more likely to occur in women over 50 years of age and with a family history of cystocele.
How the treatment is carried out
The treatment of cystocele must be guided by the gynecologist and may vary according to the degree of the cystocele, and it may be recommended to perform Kegel exercises, which help to strengthen the pelvic floor muscles, hypopressive gymnastics, placement of a pessary, use of medication hormones, especially in the case of menopause and, in the most serious cases, surgery. See more details on the treatment for low bladder.
