Also known as:
Urethrocele, Prolapsed bladder, Cystocele
Two common forms of pelvic organ prolapse are bladder prolapse (cystocele) and urethral prolapse (urethrocele). A cystocele occurs when the wall of the bladder presses against and moves the wall of the vagina. A urethrocele occurs when the tissues surrounding the urethra sag downward into the vagina. Both conditions are easy for your doctor to see during a physical exam. They often occur at the same time and are usually caused by damage that happens when a baby is delivered through the mother's birth canal (vagina).
While many women have some degree of bladder and urethral prolapse, few ever have any symptoms, or the symptoms do not appear for years. When symptoms do appear, they may include difficulty urinating, involuntary release of urine (urinary incontinence), and pain during sexual intercourse. Surgery is not required unless your symptoms interfere with daily activities.
Unless another health problem is present that would require an abdominal incision, the bladder and urethra are usually repaired through an incision in the wall of the vagina. This surgery pulls together the loose or torn tissue in the area of prolapse in the bladder or urethra and strengthens the wall of the vagina to prevent prolapse from recurring.
There are several types of surgery to correct stress urinary incontinence. These surgeries lift the urethra and/or bladder into their normal position. To learn more about these surgical procedures, see the topic Urinary Incontinence in Women.
Pelvic organ prolapse is often caused or made worse by labor and vaginal delivery, so you may want to delay surgical repair until you have finished having children.
Surgical repair may relieve some, but not all, of the problems caused by a cystocele or urethrocele. If pelvic pain, low back pain, or pain with intercourse is present before surgery, the pain may still occur after surgery. Symptoms of urinary incontinence or retention may return or get worse following surgery.
You can control many of the activities that may have contributed to your cystocele or urethrocele or made it worse. After surgery:
- Avoid smoking.
- Stay at a healthy weight for your height.
- Avoid constipation.
- Avoid activities that put strain on the lower pelvic muscles, such as heavy lifting or long periods of standing.