What is cystocele? How much time does it take in cystocele repair recovery? Keep reading to know your answers…
A cystocele is a medical condition, where the wall between the urinary bladder and vagina, in a woman, weakens causing the bladder to displace out of its anatomical position. The bladder gradually droops into the vagina causing painful urination, which is a conspicuous symptom. This condition is also referred to as fallen or prolapsed bladder. In a few cases, emptying of bladder can get triggered with the slightest cough, laugh or sneeze. Cystocele can be classified into three kinds, grade 1 cystocele (bladder drooping into vagina), grade 2 her (bladder almost falls into the vaginal opening) and grade 3 cystocele (bladder almost bulges out of the vaginal opening). Many a time, a woman suffers from this disorder, due to severe muscle straining during labor or heavy weightlifting, or strained bowel movements. Estrogen helps in strengthening the vaginal muscles, however during menopause, when the hormone secretion drops, the muscles weaken causing cystoceles. In such cases, women are recommended hernia repair.
Cystocele Repair Procedure and Recovery Time
Surgery is recommended if the cystoceles are of grade 2 or grade 3 types. If the cystoceles are mild, they can be rectified by following certain instructions from the doctor like, avoiding heavy weightlifting and practicing Kegel exercises. These exercises involve isometric contraction of the pubococcygeus muscle, which is purely aimed at strengthening the bladder to help in holding the urine. 8 – 10 contractions, in 3 sets is advised, where each contraction is held for 1 – 10 seconds. Electrical stimulation, biofeedback devices can be used with weighted vaginal cones to help in identifying the correct muscle containing defect and contracting it. However, if the hernia is of grade 3, surgical techniques are adopted.
Cystocele repair is carried out by a surgical technique, anterior colporrhaphy. The patient is first given general anesthesia, before the surgery. Then a speculum is inserted into the vagina, where an incision is made into the skin to clearly identify the underlying fascia. Once identified, the vaginal skin is separated and the bladder is positioned correctly. Once the defect is corrected, excess vaginal skin is removed and the incision is stitched back. Strong sutures are used to reinforce the weakened tissue and the stitches need not be removed as they disappear over a period of time. Other surgical techniques like perineorrhaphy involve surgical shortening and tightening of the perineum to correct the defect.
The above mentioned surgeries are performed by a gynecologist or a urologist or a urogynecologist. If the cystocele is not quite severe, pessaries (a prostheses) are inserted into the vagina to maintain the right bladder position. However, extra care must be taken in this method, by regularly cleaning the instrument, as otherwise there are chances of infection infesting in vagina, causing vaginal ulceration. Hence, if the cystoceles are of grade 1 or grade 2, the surgical procedure is outpatient, otherwise the patient may be put on bed rest for several days. The approximate cystocele repair recovery time is about 4 – 6 weeks. Immediately after surgery, a urethral catheter is kept inserted for < 24 hours to help in bladder positioning. In the next 2 - 3 weeks, prescription drugs like Tylenol and Ibuprofen are given to palliate the pain. The patient is advised against lifting anything heavy or indulging in any intercourse for at least 3 months post surgery. Also the patient will be put on a liquid diet until normal bowel functioning is resumed. However, the above mentioned surgical procedures have their shares of risks and complications. Some of the complications include infected vagina, bleeding, internal injury to pelvic structures, painful intercourse and a recurrent prolapse. Another important point to remember, surgery comes across as a good option for rectifying the bladder displacement only, if the woman does not plan to have children in future, as recurrence of prolapses are not guaranteed. Secondly, ignoring such warnings can prove perilous to women’s health as the risk factors associated with the procedures are quite grave. Hence, women while approaching menopause, should start consuming estrogen rich foods like apples, grapes, dates, lentils, carrots, cherries, papayas etc. to increase the hormone levels naturally, thereby preventing such prolapses.