A cystocele may be asymptomatic in some women. In others, it may cause the following symptoms:
- A soft bulge of tissue in the vagina that protrudes through the vaginal opening
- Pelvic pressure or heaviness
- Difficulty emptying the bladder
- The need to press one’s fingers into the vagina to reduce the bulge (splint) or the need to reposition to empty the bladder
The three main factors that contribute to the development of a cystocele are:
- Hereditary. Cystoceles tend to run in families. There are genes that code for the supporting structures of the pelvic floor and variations in these genes can lead to weakening of the pelvic floor.
- Childbirth. Vaginal deliveries can stretch and weaken the supporting structures of the pelvic floor.
- Age. Supporting structures of the pelvic floor weaken with increased age.
Treatment for cystocele ranges from no treatment for a mild and asymptomatic cystocele to surgery or a pessary for a more advanced cystocele.
A pessary is typically used in women who are not candidates for surgery due to age or poor health.
Surgery is elective and done to relieve symptoms. Symptoms of prolapse do not decrease without treatment. Reconstructive surgeries are done to restore the anatomy of the vagina; these include vaginal prolapse repair or robotic sacrocolpopexy. The type of surgery recommended is based on each individual’s exam and desired outcome