Type of Surgery
Information
Last updated: 02/17/2009
Surgery is generally reserved for more severe cystoceles. Milder cases may be treated by a number of medical interventions. The physician may recommend that the patient do Kegel exercises, a series of contractions and relaxations of the muscles in...
the perineal area. These exercises are thought to strengthen the pelvic floor and may help prevent urinary incontinence.
A pessary, a device that is inserted into the vagina to help support the pelvic organs, may be recommeded. Pessaries come in different shapes and sizes and must be fitted to the patient by a physician. Hormone replacement therapy may also be prescribed if the woman has gone through menopause; hormones may improve the quality of the supporting tissues in the pelvis.
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Definition
A cystocele is the protrusion or prolapse of the bladder into the vagina. A number of surgical interventions are available to treat cystoceles.
Purpose
A prolapse occurs when an organ falls out of its normal anatomical position. The pelvic organs normally have tissue (muscle, ligaments, etc.) holding them in place. Certain factors, however, may cause those tissues to weaken, leading to prolapse of the organs. A cystocele may be the result of a central or lateral (side) defect. A central defect occurs when the bladder protrudes into the center of the anterior (front) wall of the vagina due to a defect in the pubocervical fascia (fibrous tissue that separates the bladder and vagina). The pubocervical fascia is also attached on each side to tough connective tissue called the arcus tendineus; if a defect occurs close to this attachment, it is called a lateral or paravaginal defect. A central and lateral defect may be present simultaneously. The location of the defect determines what surgical procedure is performed.
Other Information
As a urologist, I've found it's easier to do the PSA test and then sit down with the patient and say here's what the results mean for you. Given what we know right now, that seems a very sensible approach.
-Dr. Evan Vapnek
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