Pronounced: SIS-tuh-seal/REK-tuh-seal
En Espaol (Spanish Version)Definition
A cystocele occurs when part of the bladder bulges into the vagina. A rectocele occurs when part of the rectum sags into the vagina. In both conditions, the walls of the vagina weaken so they are not strong enough to support a separation between the vagina and the bladder or rectum.
There are three grades of cystocele:
- Grade 1: the mildest form, where the bladder drops only partway into the vagina
- Grade 2: a moderate form, where the bladder has sunken far enough to reach the opening of the vagina
- Grade 3: the most severe form, where the bladder sags through the opening of the vagina
The sooner that cystocele or rectocele are treated, the more favorable the outcome. If you suspect you have this condition, contact your doctor.
Cystocele
2008 Nucleus Medical Art, Inc.
Rectocele
2008 Nucleus Medical Art, Inc.
Causes
Cystocele and rectocele occur when the walls of the vagina have been damaged, usually by one or more of the following factors:
- Difficult vaginal births
- Multiple births
- The use of forceps to assist delivery
- Perineal tears during delivery
- Episiotomy during birth
- Strain from lifting heavy objects
- Chronic cough
- Chronic constipation
- Weakening of vaginal muscles caused by a lack of estrogen after menopause
Risk Factors
The following factors increase your chance of developing cystocele and rectocele. If you have any of these risk factors, tell your doctor:
Age: postmenopausalHistory of difficult vaginal birthsHistory of straining during bowel movementsObesitySmoking SymptomsMany cases of cystocele and rectocele are mild and do not have symptoms. In more serious cases, the symptoms of cystocele include: Urine leakage while laughing, sneezing, or coughingIncomplete bladder emptying after urinationPain or pressure in the pelvisFrequent bladder infectionsPain during sexual intercourseFeeling of tissue bulging out of vagina Symptoms of rectocele include: Pain or pressure in the vaginaPain during sexual intercoursePain or pressure in the rectumDifficult passage of stoolNeeding to apply pressure on vagina to pass stoolFeelings of incomplete stool passageFeeling of tissue bulging out of vaginaIf you experience any of these symptoms, do not assume it is due to cystocele or rectocele. These symptoms may be caused by other, less or more serious health conditions. If you experience any one of them, see your physician. Diagnosis Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests for cystocele may include the following: Pelvic examinationVoiding cystourethrograman x-ray test done during urinationUrine tests to look for signs of infection Tests for rectocele may include:
Examination of the vagina and rectumDefecagraman x-ray test done during defecation TreatmentTalk with your doctor about the best treatment plan for you. For the mildest cases of cystocele and rectocele, no treatment is needed. For more serious cases, treatment options include the following: Activity ModificationFor cystocele and rectocele, your doctor may suggest that you avoid heavy lifting.Kegel exercises (squeezing the pelvic floor muscles) may help to strengthen the muscles around the vagina and bladder.For rectocele, the first line of treatment is often a diet that allows for easy passage of stools. This includes adding fiber, liquids, and a stool softener if necessary. PessaryA pessary is a device that is inserted into the vagina to provide support and to keep the bladder and/or rectum in place. Estrogen Replacement Therapy Adding estrogen (in the form of pills, creams, or patches) may help strengthen the walls of the vagina after menopause . SurgeryFor severe cases of cystocele and rectocele, surgery may be needed to move the bladder or rectum back into place. Prevention To help reduce your chances of getting cystocele and rectocele, take the following steps: Avoid heavy lifting.Perform Kegel exercises regularly.Treat constipation.Quit smoking.Maintain a healthy weight. RESOURCES:
American Society of Colon and Rectal Surgeonshttp://www.fascrs.org National Kidney and Urologic Diseases Information Clearinghousehttp://www.kidney.niddk.nih.gov Society of Gynecologic Surgeonshttp://www.sgsonline.org/ UrologyHealth.orghttp://www.urologyhealth.org CANADIAN RESOURCES: Canadian Urological Associationhttp://www.cua.org Women's Health Mattershttp://www.womenshealthmatters.ca/index.cfm References: Cystocele. University of Michigan Health System website. Available at: http://www.med.umich.edu/1libr/wha/wha_cystocel_crs.htm . Accessed September 22, 2005. Cystocele (fallen bladder). National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://www.kidney.niddk.nih.gov/kudiseases/pubs/cystocele . Accessed January 13, 2008. Cystocoele, rectocoele, and pelvic support surgery. Society of Gynecologic Surgeons website. Available at: http://www.sgsonline.org/edpro002.html . Accessed January 13, 2008. Rectocele. American Society of Colon and Rectal Surgeons website. Available at: http://www.fascrs.org/displaycommon.cfm?an=1&subarticlenbr=19 . Accessed January 13, 2008.
Rectocele. Mayo Clinic website. Available at: http://www.mayoclinic. com/invoke.cfm?id=AN00529 . Accessed January 13, 2008. Last reviewed January 2008 by Adrienne Carmack, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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