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There are various pelvis organs, namely the bladder, uterus, and intestines. The pelvic floor’s muscles and connective tissues hold these organs in place. Now, when the pelvic floor becomes weak, or when it experiences too much pressure it can result in a condition called an anterior prolapse. Here the pelvic organs slip down from their normal position into the vagina. This usually happens due to factors like vaginal childbirth, constant heavy lifting, chronic constipation, and violent coughing. Let’s understand the condition in detail.
Anterior vaginal prolapse is also known as a cystocele or a prolapsed bladder. It refers to a condition where the bladder drops from its original position in the pelvis and hence puts pressure on the wall of your vagina. The anterior wall of the vagina is supported by connective tissues and muscles. When these supporting structures are damaged or weakened, the bladder tends to descend into the vaginal space leading to the formation of a cystocele. This condition is more common in women who have gone through childbirth or menopause.
This condition can be treated with both non-surgical and surgical measures. Non-surgical measures include exercises and certain lifestyle changes. More severe cases would require surgical intervention.
As discussed, one’s pelvic floor consists of ligaments, muscles, and connective tissues, which all support the bladder and other pelvic organs. If these supporting structures weaken with time or due to certain stress-causing factors, the bladder may slip down and bulge into the vagina. These factors include:
Furthermore, there are several risk factors associated with anterior prolapse:
In mild cases, there might not be any signs or symptoms. However, if they do occur, they include the following:
One may note here that the symptoms are especially noticeable after standing for long time periods. They may even go as you lie down.
Diagnosing an anterior prolapse may involve the following:
A pelvic examination: Here, the doctor examines you while you lie down and/or stand. The doctor will look for the presence of a visible tissue bulge in your vagina, which would be an indication of cystocele. The degree of prolapse will be found out by making you bear down as if during a bowel movement. Moreover, you’ll be asked to contract the pelvic floor muscles to check the muscle strength; this you can do by trying to stop the urine stream.
Filling out a questionnaire: This is to provide the examiner with information about your medical history, the degree of prolapse, and its effect on your life.
Bladder and urine tests: In case of a prolapse, tests might be carried out to find out the degree to which your bladder empties and whether there also exists a bladder infection. The latter is done through a test on a urine sample.
Treating an anterior prolapse is dependent on your symptoms, the severity of the prolapse, and the presence of any related conditions (such as urinary incontinence, or more than one type of pelvic organ prolapse). Mild cases with few or no signs may not require immediate treatment. They can be monitored over time. If symptoms are noticeable, the first-line treatment will involve the following options:
Non-Surgical Measures
Surgical Measures
It may be noted here that if you are pregnant and having a cystocele, you’ll need to delay surgery until childbirth.
Cystocele can be prevented by controlling the associated risk factors. Some of the preventive measures are:
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