Cystocele

A “cystocele” (pronounced: cysto-oh-seal) is the bladder dropping into the vagina.

Normally, there is a supportive tissue layer called “fascia” that lies between the bladder and the vagina. The role of this tissue layer is to keep the bladder supported, and prevent the bladder from sagging or herniating into the vagina.

There are two places from where the bladder can lose its support. If you imagine that the bladder is like a hammock, you know that each ends of the hammock are attached by ropes to trees. The center of the hammock is made out of durable cloth.

1. One problem can occur, in the center of the hammock… for instance, imagine a heavy person sitting on the hammock day after day. When he/she stands up, the of the hammock sort of sags. This situation mimics one type of cystocele – when the central area of tissue between the bladder and the vagina gets weakened, the central part of the bladder drops.

2. Another problem occurs, when the ropes that attach the hammock to the trees stretch out/elongate. This situations mimics a type of cystocele known as a “paravaginal” defect – which means the sides of the bladder have torn or stretched off of their attachments.

Type of Cystoceles

The type of cystocele you have only becomes important when surgery is to be performed to repair it because each type calls for a different surgical procedure. If the proper surgical procedure is not done, there is a higher chance of failure.

The first type of cystocele (“central defect”) can be surgically repaired through the vagina with essentially no discomfort. The success rates are generally 80-85% successful.

The second type of cystocele can be surgically repaired either through the vagina or through an abdominal incision. Depending on the surgeon and the quality of the tissues, however, one route may be preferable to the other. You and your surgeon will discuss this.

Unfortunately, no surgical procedure is 100% guaranteed. Cystoceles are very hard to correct completely, usually because the tissue we need to repair it with is weakened to begin with (that is why you have the problem in the first place!)
Performing the proper procedure for your type of cystocele is very important to assure the best success possible.