Cystocele is a condition of prolapse in the anterior region of the pelvic. It is usually associated with the prolapse of the bladder.
Cystocele presents discomforting conditions and can be treated through surgical or non-surgical methods.
The non-surgical symptoms can be treated depending on the intensity of the prolapse. The symptoms in themselves decide if the condition can be treated non-surgically.
A severe anterior prolapse is a condition with one or more organ prolapse.
Mild conditions of prolapse do not show obvious symptoms, and do not need specific treatment but need to be monitored.
These are a set of exercises especially for strengthening the pelvic floor muscles, often referred to as Kegel's exercise.
These exercises offer good support for your bladder and other pelvic organs. They would relieve a patient of the symptoms but do not reverse the extent of the prolapse.
A pessary is a vaginal supportive device that is implanted in the pelvic region to support the pelvic organs.
It is a plastic or a rubber ring that merely acts as a support, but does not cure the prolapse, or relieves the patient of the symptoms.
The doctor instructs how the device can be installed and removed to clean it regularly and maintain hygiene. Although it is a temporary and merely supportive measure, and not a curative one.
Some other care you can take at home to control the cystocele symptoms are -
Eat high-fiber foods to prevent constipation.
Avoid lifting heavy lifting that could put stress on the pelvic region and aggravate the prolapse symptoms.
The patient should keep the cough in control, as it might again put pressure on the pelvic area.
Weight management, especially in the abdominal area.
Under laparoscopic surgery, three to four incisions are made in the abdomen, and carbon dioxide gas is passed through the incision to inflate the abdomen.
The doctor passes a thin tube with a lighted camera at one end called a Laparoscope. This camera guides the doctor in performing the procedure by looking at the nearby screen.
In cystocele repair, the doctor works on relapse of the anterior organs of the pelvic region and tries to strengthen the pelvic wall either through the natural tissues or by making use of a surgical mesh.
Once the process is completed, the incisions are sutured.
In some severe cases of anterior prolapse, the doctor might also perform a hysterectomy (removal of the uterus).
Open Surgery
Open surgery can be performed through the abdominal or vaginal way. The doctor makes a big cut in the abdomen below the navel or in the vaginal region, to gain access to the prolapse.
The doctor carries out the same procedure as a laparoscopic one, only through an open approach for better reach and visibility.
Cystocele repair and associated risks-
Urinary incontinence
Painful intercourse
Bladder injury
Urinary retention
Infection
Formation of fistula (an abnormal opening between two organs).
If the prolapse is left untreated for a long time it may get worse. In some cases, severe prolapse can cause an obstruction of the kidneys or even urinary retention (inability to pass urine). This may eventually lead to kidney damage or infection.
In advanced cases of prolapse, the vaginal wall that supports the bladder might also collapse and will drop out of the vagina, causing a bulge that is very uncomfortable.
You may have to stay one to two days at the hospital for observation after the surgery.
One or more side effects might be seen after surgery like:
Post-operative pain.
Mild cramping sensation in the abdomen.
Nausea
Fatigue
Constipation
Visit the doctor if they persist for more than a week.
One can take a few measures to ensure better recovery like:
Take pain medication as prescribed by the doctor for post-operative pain (if any) and visit the physician, if it worsens or does not subside even after a week.
Avoid soaking the bandages at the operated site for 2 weeks during bathing.
Take small walks daily to prevent blood clot formation in the legs.
Heavy weight lifting and driving must be restricted for two at least weeks after surgery.
Avoid strenuous physical activities that could cause pressure in the abdominal and pelvic region.
Avoid sexual activity for four to six weeks after surgery.
Eat a healthy diet and maintain adequate fluid intake daily.
Visit your doctor after surgery as advised for follow up appointments.
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