cystocele; vesicocele; bladder prolapse; anterior prolapse

Introduction

Prolapse or herniation of the urinary bladder, usually into the vagina. A cystourethrocel involves the bladder & the urethra.

Etiology

• labor & delivery
• other strain on pelvic muscles
  • strain during lifting heavy objects
  • repeated strain with bowel movements
• estrogen depletion

Clinical manifestations

• pelvic pressure, heaviness or a feeling that something has fallen down

Diagnostic procedures

• voiding cystourethrogram

Complications

• urethra may become compressed or kinked leading to urinary overflow incontinence

Management

• asymptomatic urinary prolase requires no treatment
• pessary
  • ring pessary for mild to moderate prolapse
  • Gellhorn pessary for moderate to severe prolapse
  • cube pessary
    • insufficient vaginal tone to support other pessaries
    • must be removed daily
  • treatment of choice in patients with comorbid conditions
• bladder suspension surgery

More general terms

• pelvic organ prolapse

Additional terms

• prolapse of the uterus; cervical incompetence; pudendal hernia

Patient information

cycstocele patient information