Description

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

The organs of the pelvis, including the bladder, uterus, and intestine — is usually performed in place by the muscles and the connective tissue of the pelvic floor muscles. Previous prolapse occurs when the pelvic floor is weak or if the excess pressure on the pelvic floor. This can happen over time, during vaginal childbirth or with chronic constipation, violent coughing or lifting heavy objects.

Anterior prolapse is treatable. For a mild or moderate prolapse, non-surgical treatment is often effective. In more severe cases, surgery may be necessary to keep the vagina and other pelvic organs in their correct positions.

Symptoms

In mild cases of prolapse of the foregoing, you may not notice any signs or symptoms. When the signs and symptoms, which may include:

  • A feeling of fullness or pressure in the pelvis and vagina
  • In some cases, a bulge of tissue in your vagina that you can see or feel
  • The increase of pressure in the pelvis to the effort, cough, push or lift
  • Urinary problems, like difficulty starting the stream of urine, the feeling that you have not completely emptied your bladder after urinating, feeling of a frequent need to urinate, or leakage of urine (urinary incontinence)

Signs and symptoms are often especially noticeable after standing for long periods of time and may disappear when you lie down.

When to see a doctor

A prolapse of the bladder can be uncomfortable, but is rarely painful. You can do the emptying of the bladder difficult, which can lead to infections of the bladder. Make an appointment with your health care provider if you have any of the signs or symptoms that bother you or impact of their daily activities.

Causes

Your pelvic floor is composed of muscles, ligaments and connective tissues that support the bladder and other pelvic organs. The connections between organs of the pelvis and ligaments can weaken over time, or as a result of birth trauma or chronic effort. When this happens, the bladder can drop lower than usual and a bulge in the vagina (prolapse above).

Causes of stress to the pelvic floor include:

  • Pregnancy and vaginal delivery
  • Overweight or obesity
  • Repeated lifting of heavy objects
  • Straining with bowel movements
  • A chronic cough or bronchitis

Risk factors

These factors can increase the risk of prolapse previous:

  • Pregnancy and childbirth. Women who have had a vaginal or instrument-assisted delivery, multiple pregnancies, or whose infants had a high birth weight have a higher risk of prolapse before.
  • Aging. The risk of prolapse previous increases with age. This is especially true after menopause, when your body's production of estrogen, which helps to keep the pelvic floor strong — decreases.
  • The hysterectomy. Removing the uterus may contribute to the weakness in the floor of the pelvis, but this is not always the case.
  • Genetics. Some women are born with the weaker of the connective tissues, making them more susceptible to anterior prolapse.
  • Obesity. Women who are overweight or obese are at higher risk of prolapse before.

Diagnosis

The diagnosis of prolapse may involve:

  • A pelvic examination. You may be examined while lying down and, possibly, while standing. During the exam, your doctor will look for a tissue bulge into your vagina that indicates the prolapse of pelvic organs. Probably he was asked to bid as if during a bowel movement to see how much that affects the degree of prolapse. To check the strength of the pelvic floor muscles, you will be asked to engage with them, as if you are trying to stop the flow of urine.
  • The completion of a questionnaire. You can fill out a form that helps your provider to assess your medical history, the degree of prolapse and how much it affects their quality of life. This information helps to guide treatment decisions.
  • And of the bladder of urine. If you have a prolapse, it could be a test to see how well and completely your bladder empties. Your provider may also run a test on a urine sample to look for signs of a bladder infection, if it seems that you are to hold more urine in the bladder that is normal after urinating.

Treatment

The treatment depends on whether you have symptoms, the severity of his previous prolapse and if you have any of the related conditions, such as urinary incontinence, or more than one type of prolapse of the pelvic organs.

Mild cases — those with few or no obvious symptoms — usually do not require treatment. Your healthcare provider may recommend a wait-and-see, with occasional visits to monitor your prolapse.

If you have symptoms of prolapse earlier, in the first-line treatment options include:

  • Exercises for the pelvic muscles.These exercises, often called Kegel exercises or pelvic floor exercises — to help strengthen the muscles of the pelvic floor, so it can better support the bladder and other pelvic organs. Your doctor or physical therapist can give you instructions on how to do these exercises and can help you determine if you are doing it correctly.
  • A support device (spfs). A vaginal pessary is a plastic or rubber ring inserted into the vagina to support the bladder. A pessary is not correct or cure the actual prolapse, but the additional support that the device provides, you can help relieve the symptoms. Your doctor or other care provider suits you for the device, and shows how to clean and re-insert it into your own. Many women using pessaries as a temporary alternative to surgery, and some of them when the surgery is too risky.

Exercises for the pelvic muscles. These exercises, often called Kegel exercises or pelvic floor exercises — to help strengthen the muscles of the pelvic floor, so it can better support the bladder and other pelvic organs. Your doctor or physical therapist can give you instructions on how to do these exercises and can help you determine if you are doing it correctly.

Kegel exercises can be most successful in the relief of symptoms when the exercises are taught by a physical therapist and reinforced with biofeedback. Biofeedback involves the use of monitoring devices that help to make sure that you are squeezing the right muscles with optimal intensity and duration of the time. These exercises can help to improve the symptoms, but may not decrease the size of the prolapse.

When surgery is necessary

If you still have remarkable, uncomfortable symptoms despite treatment, the above options, you may need surgery to correct prolapse.

  • How it is done. Often, the surgery is performed vaginally and consists of lifting the prolapse of the bladder in place the use of stitches, and the removal of any excess vaginal tissue. Your doctor may use a special type of tissue graft to strengthen the vaginal tissues and increase the support if your vaginal tissues appear to be very thin.
  • If you have a prolapsed uterus. To prolapse earlier associated with a prolapsed uterus, your doctor may recommend the removal of the uterus (hysterectomy), in addition to repair the damaged pelvic floor muscles, ligaments and other tissues.
  • If you have incontinence. If the prolapse of the above is accompanied by stress urinary incontinence — leakage of urine during strenuous activity — the doctor also may recommend one of a series of procedures to support the urethra (suspension urethral) and relieve your symptoms of incontinence.

If you are pregnant or thinking about becoming pregnant, you might need to delay the surgery until after you have finished having children. Pelvic floor exercises or a pessary can help relieve your symptoms in the meantime. The benefits of the surgery can last for many years, but there is a certain risk of prolapse happening again — which may mean another surgery at some point.

Lifestyle and home remedies

Kegel exercises are exercises that you can do at home to strengthen the muscles of the pelvic floor. Strengthening of the pelvic floor provides a better support for your pelvic organs and the relief of symptoms associated with prolapse of the above.

To perform Kegel exercises, follow these steps:

  • Tighten (contract) your pelvic floor muscles — the muscles you use to stop urinating.
  • Hold the contraction for five seconds, and then relax for five seconds. (If this is too difficult, start with the celebration of two seconds and relax for three seconds.)
  • Work up to holding the contraction for 10 seconds at a time.
  • Do three sets of 10 repetitions of the exercises of each day.

Ask your doctor for instructions on how to properly perform a Kegel exercise, and for information on whether you are using the right muscles. Once you have learned the correct method, you can do Kegel exercises discreetly just about any time, if you are sitting at your desk or relaxing on the couch.

To help maintain a previous prolapse progress, you can also try these lifestyle modifications:

  • Treat and prevent constipation. Foods rich in fiber can help.
  • Avoid lifting heavy objects, and to lift correctly. When it rises, the use of the legs in place of the waist or the back.
  • Control the cough. Receive treatment for a chronic cough or bronchitis, and do not smoke.
  • Control your weight. Talk with your doctor to determine your ideal weight and get tips on weight loss strategies, if needed.

Preparing for your appointment

Make an appointment with your gp or gynaecologist if you have signs or symptoms of prolapse of the anterior disturb or interfere with their normal activities.

Here's some information to help you prepare for your appointment and know what to expect from your doctor.

What you can do

  • Write down any symptoms you've had, and for how long.
  • Take note of the key medical information, including other conditions for which you are being treated, and the names of the medications, vitamins or supplements that you take regularly.
  • Bring a friend or relative, if possible. Have someone else you can help you remember important information, or provide details about something that has been lost during the appointment.
  • Write questions to ask to your provider, the list of the most important first in the case of time runs short.

To prolapse earlier, some basic questions to ask include:

  • What is the most likely cause of my symptoms?
  • There are other possible causes?
  • Do I need any tests to confirm the diagnosis?
  • What treatment approach do you recommend?
  • If the first treatment does not work, what would you recommend then?
  • Am I at risk of complications of this condition?
  • What is the probability that the previous prolapse recurrence after the treatment?
  • Should I continue any activity restrictions?
  • What can I do at home to relieve the symptoms?
  • You should see a specialist?

In addition to the questions that are prepared in advance, please do not hesitate to ask questions during your appointment if you need any clarification.

What to expect from your doctor

During your appointment, your doctor may ask a series of questions, such as:

  • When did you first notice your symptoms?
  • Do you have loss of urine?
  • Do you have frequent infections of the bladder?
  • Do you have pain or loss of urine during sexual intercourse?
  • Do you have a chronic illness or severe cough?
  • You are experiencing constipation and straining during defecation?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Does your mother or a sister you have any pelvic floor issues?
  • Has delivered a baby vaginally? How many times?
  • Do you want to have children in the future?
  • What you worry about most?
Symptoms and treatment of vaginal prolapse Anterior (cystocele)