If the symptoms are moderately bothersome, the doctor may recommend a pessary – a device placed in the vagina to keep the bladder in place. The pessaries come in a variety of shapes and sizes to allow the doctor to find the most comfortable fit for the patient. Pessaries should be removed regularly to avoid infections or ulcers. Severe cystocele may require surgery to keep the bladder in a more normal position. This operation can be performed by a gynecologist, a urologist or a urogynecologist. The most common procedure for cystocele repair is for the surgeon to make an incision in the wall of the vagina and repair the area by tightening the layers of tissue that separate the organs, creating more support for the bladder. The patient can stay in the hospital for several days and take 4 to 6 weeks to fully recover. Risks The risks of repair of cystocele and urethrocele include: Urinary incontinence Urinary retention. Painful sexual relationships Infection. Bladder injuries Formation of an abnormal connection or opening between two organs (fistula).
A rectocele occurs when front wall of the rectum bulges against the posterior of the vagina. Learn more from our experts. What is a rectocele? A rectocele is a condition in which the wall of tissue that separates the rectum from the vagina is weakened, allowing the vaginal wall to budge. Commonly, the front wall of the rectum bulges against the posterior of the vagina. The size of the prolapse often indicates if it is symptomatic. If the prolapse is small they can be asymptomatic (no symptoms). Larger prolapses however, may create a noticeable bulge through the vaginal opening. In severe cases, surgery is recommended for repair of the rectocele. What are the symptoms of a rectocele? This shows the rectum which has been herniated into the vagina. A small posterior prolapse may cause no signs or symptoms.
Rectocele and related problems A rectocele sometimes occurs by itself. In other cases, the woman may also have other problems including: Cystocele – the bladder protrudes into the vagina Enterocele – the small intestines push down into the vagina Uterine prolapse – the cervix and uterus drop down into the vagina and may protrude out of the vaginal opening Vaginal prolapse – in cases of severe uterine prolapse, the vagina may slide out of the body too Rectal prolapse – the rectum protrudes through the anus. Treatment for rectocele A rectocele should only be treated if you are having significant symptoms that interfere with your quality of life. Prior to any treatment, there should be a thorough evaluation by your doctor. There are both medical and surgical treatment options for rectoceles. The majority of symptoms associated with a rectocele can be resolved with medical management; however, treatment depends on the severity of symptoms. Surgical treatment is reserved for only the most severe cases of symptomatic rectocele.
Aging. Your risk of anterior prolapse increases as you age. This is especially true after menopause, when your body's production of estrogen — which helps keep the pelvic floor strong — decreases. Hysterectomy. Having your uterus removed may contribute to weakness in your pelvic floor, but this is not always the case. Genetics. Some women are born with weaker connective tissues, making them more susceptible to anterior prolapse. Obesity. Women who are overweight or obese are at higher risk of anterior prolapse. Anterior prolapse (cystocele) care at Mayo Clinic April 21, 2020 AskMayoExpert. Pelvic organ prolapse. Mayo Clinic; 2019. AskMayoExpert. Pelvic floor dysfunction. Mayo Clinic; 2018. Rogers RG, et al. Pelvic organ prolapse in women: Epidemiology, risk factors, clinical manifestations, and management.. Accessed Jan. 31, 2020. American College of Obstetricians and Gynecologists. Practice Bulletin No. 176: Pelvic organ prolapse. Obstetrics & Gynecology. 2017; doi:10. 1097/AOG. 0000000000002016.
Patient's guide Severe cystocele may require reconstructive surgery called anterior repair to move the bladder to a normal position. In this type of surgery, an incision (cut) is made in the wall of the vagina and the tissue that separates the bladder from the vagina is tightened. The surgeon may also implant permanent mesh grafts made of synthetic or biological materials to improve vaginal support. The patient usually goes home the day after the surgery. Complete recovery usually takes four to six weeks. For women who never plan to have sex again, the surgeries that sew the vagina and shorten it are almost 100% effective. These techniques are best done in elderly patients with multiple medical problems that would make reconstructive surgery a high risk. What is the prognosis for someone with a cystocele? Although it does not threaten life, the cystocele can have a negative impact on a woman's quality of life. If it is not treated at all, the condition may continue to get worse. In the worst cases, the woman may be unable to urinate, which can cause kidney damage or infection.
All types of surgery, including cystocele and rectocele, have risks such as infection and bleeding. A cystocele occurs when the barrier between the vagina and the bladder, known as the vaginal wall, is torn or severely weakened during childbirth. This results in the bladder protruding into the vagina. Similarly, a rectocele occurs when the rectum protrudes into the vagina due to a tear or weakening of the barrier between the rectum and the vagina, which is also part of the vaginal wall. Cystocele and rectocele surgery is generally carried out in the same manner, with the main difference between them being that cycetocele surgery aims to prevent the bladder from protruding into the vagina while rectocele surgery aims to prevent the rectum from protruding into the vagina. This means that they are performed on different portions of the vaginal wall. Rectocele repair is a surgical procedure carried out to correct a prolapse of the rectum. The main type of cystocele and rectocele surgery is known as colporrhaphy.
(Pelvic Relaxation; Bladder Prolapse; Fallen Bladder/Rectocoele; Protruding Rectum) Pronounced: SIS-tuh-seal/REK-tuh-seal by Nicky Lowney, MA A cystocele occurs when part of the bladder wall bulges into the vagina. The bulge happens through a defect in the fascia. This is the connective tissue that separates the vagina from the bladder. There are three grades of cystocele: Grade 1: mildest form, where the bladder drops only partway into the vagina Grade 2: moderate form, where the bladder has sunken far enough to reach the opening of the vagina Grade 3: most severe form, where the bladder sags through the opening of the vagina A rectocele occurs when part of the wall of the rectum bulges into the vagina. The bulge happens through a defect in the fascia between the rectum and vagina. © 2009 Nucleus Medical Art, Inc. The sooner that cystocele or rectocele are treated, the more favorable the outcome. If you suspect you have this condition, contact your doctor.
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Some people may experience different types of prolapse at the same time, such as both an anterior and posterior vaginal wall prolapse. A small rectocele may cause no symptoms. According to the American Society of Colon and Rectal Surgeons, health professionals carrying out routine physical examinations find a rectocele is present in around 40 percent of women, although they may not notice it. In mild cases of rectocele, the individual may notice pressure within the vagina, or they may feel that their bowels are not completely empty after using the bathroom. In moderate cases, an attempt to evacuate can push the stool into the rectocele rather than out through the anus. There may be pain and discomfort during evacuation. There is a higher chance of having constipation, and there may be pain during sexual intercourse. Some say it feels as if "something is falling out" or down within the pelvis. In severe cases, there may be fecal incontinence, and sometimes the bulge may prolapse through the mouth (opening) of the vagina, or through the anus.