Causes and risk factors
Lifting heavy weights, straining of pelvic muscles during childbirth, obstetric trauma or frequent straining during defecation, weakening of muscles around vagina due to lack of oestrogen after menopause leads to cystocoele.
Clinical presentation
Patient presents with discomfort during micturition, involuntary passage of urine while coughing, sneezing, and laughing, incomplete emptying of bladder, frequent urging to urinate, repeated urinary tract infections, discomfort during intercourse. When bladder passes a short way into the vagina it is grade I or mild cystocoele. When bladder droops down till the opening of vagina it is termed as grade II or moderate cystocoele. When bladder bulges out through the vaginal opening it is grade III or severe cystocoele.
Investigation
Medical history by the patient and Clinical examination by the gynaecologist helps in diagnosis. Grade II and III cystocoeles can be diagnosed by the gynaecologist by physical examination of vagina. A voiding cystourethrogram [x-ray of bladder taken during urination] is advised in some cases.
Treatment
Grade I cystocoeles do not require any medical or surgical treatment. Doctor may advise avoidance of lifting heavy objects and straining during defecation, pelvic floor exercises, Use of pessaries [a device placed in vagina to hold bladder in place]. Severe cystocoeles require surgical correction or repair that will move bladder in place.
Other Modes of treatment
The other modes of treatment can also be effective in treating cystocoele. Homoeopathy is a science which deals with individualization considers a person in a holistic way. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating grade I cystocoele. Yoga techniques help in treatment of cystocoele.
Recent updates
Recent studies show the effective use of synthetic meshes in surgical repair of cystocoele.
