Anterior prolapse (cystocele)

Anterior vaginal prolapse, also known as a cystocele (SIS-toe-seel) or a prolapsed bladder, is when the bladder drops from its normal position in the pelvis and pushes on the wall of the vagina.

The organs of the pelvis including the bladder, uterus and intestines are normally held in place by the muscles and connective tissues of the pelvic floor. 

Anterior prolapse occurs when the pelvic floor becomes weak or if too much pressure is put on the pelvic floor. This can happen over time, during vaginal childbirth or with chronic constipation, violent coughing or heavy lifting.

Anterior prolapse is treatable. For a mild or moderate 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.

What is Anterior prolapse ?

Cystocele (SIS-toe-seel) also called, as the anterior vaginal prolapse is a condition when the urinary bladder drops from its original position in the pelvis and impinges on the vaginal wall. 

In a normal individual, the organs in the pelvis are held in position by the connective tissue and muscles of the pelvic floor. These include the urinary bladder, uterus and intestines.

During cases such as vaginal birth, chronic lifting of heavy objects over an extended period, forceful coughing and vaginal delivery of a child a lot of pressure is experienced by the pelvic floor. This can make the pelvic floor weak leading to anterior prolapse.

It is a treatable condition.

For mild to moderate prolapse, noninvasive, conservative methods have been found to be effective.

Severe cases, however, need surgery to fasten the positions of the organs in the pelvis, such that they do not hinder the normal processes of each of these organs.

What causes Anterior prolapse?

Weakening of the muscles, connective tissues and ligaments of the pelvic floor because of trauma resulting from chronic exertion or childbirth, lead to the bladder collapsing and impinging on the vagina.

The reasons responsible for stress of the pelvic floor are mentioned below:

  • Obesity

  • History of lifting heavy objects 

  • Constipation, leading to strained bowel movements

  • Bronchitis or chronic coughing

  • Pregnancy and childbirth

  • Aging

  • Hysterectomy (removal of the uterus, rare cases)

  • Genetics: Some women may be born with weak connective tissue, rendering them susceptible to anterior prolapse.

What are the symptoms for Anterior prolapse?

Signs and symptoms are not noticed for anterior prolapse in mild cases. Only in later stages following symptoms may show up:

  • Feeling of pressure in the pelvic area when bearing down, lifting or coughing

  • Some cases the bulge may be seen or felt in the vagina

  • A full feeling in the vagina or pelvis

  • Difficulty starting urination

  • A feeling that the bladder is not completely empty, even after urination

  • Urinary incontinence (frequent need to urinate)

These signs may relieve themselves after lying down and reappear when standing for extended time intervals. 

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