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What is bladder or uterine prolapse – cystocele?

Bladder prolapse or cystocele is a condition where the vaginal wall adjacent to the bladder bulges due to weakness in the supporting muscles and connective tissue. This can cause a sensation of pelvic pressure, urinary problems, and discomfort during sexual intercourse. Similarly, uterine prolapse or prolapse of the uterus occurs when the uterus slides from its normal position into the vagina, which can cause similar symptoms.

Diagnosis

Diagnosing these conditions typically involves a physical examination where a doctor can directly determine the degree of bulging or prolapse. Additional diagnostic methods such as ultrasound, MRI, or urodynamic studies may help assess the extent of the prolapse and its impact on the urinary system function.

Treatment

For cystocele, anterior colporrhaphy is a popular minimally invasive option. This procedure, lasting about 20 minutes, is performed under local anesthesia and is considered painless for the patient. Interestingly, after the first urination, the patient can go home, usually within an hour. The success of the surgery is generally good but depends on the woman’s postoperative activities and genetic predispositions.

When it comes to uterine prolapse, the treatment approach varies. If the patient wishes to preserve the uterus, surgery is performed under general anesthesia. The uterus can be lifted and fixed with a band to the pelvic ligament or the front of the spine, depending on the method choice (pectineal hysteropexy or sacrohysteropexy). An alternative, without using mesh, involves a vaginal approach known as the Manchester-Fothergill operation.

For women who opt for the removal of the uterus, the surgery can be performed under local anesthesia with mild intravenous sedation. Patients can expect to be discharged home the day after the surgery, once the bladder catheter and vaginal pack are removed.

Although these surgeries are minimally invasive, they require a certain recovery time and careful postoperative monitoring. A detailed consultation with a doctor is always recommended to consider all options and choose the most suitable treatment method.