Cystocele

A cystocele is a bulge of the bladder into the front wall of the vagina. It occurs as a result of pelvic floor weakness, usually combined with a reduction or a prolapse of the vagina. In most cases, the urethra is in the bulging included ( Urethrozystozele ).

Clinical features and diagnosis

A cystocele may cause urinary incontinence, in larger cystocele also urinary retention.

In the vaginal examination with a speculum of the bladder floor is lowered and bulges the anterior vaginal wall and the anterior vaginal vault. The diagnosis is easier when the bladder and abdominal pressure. At a Zystourethrozele the folds of the bladder neck and bladder waist have elapsed, the Harnröhrenwulst is not clearly separated and doughy.

Crucial for the accurate diagnosis and the right treatment is the distinction, if there is a central or lateral defect. When Dehnungszystozele the vaginal wall has passed smoothly, at a Verlagerungszystozele the Scheidenrunzeln are obtained, however, and only their flattened lateral furrows or expired. If these are lifted with a forceps and the Zele disappears, then there is a lateral defect before (elevation test).

Treatment

Treatment is usually surgical. In a Dehnungszystozele can a front vaginal repair ( anterior colporrhaphy ) are performed. In a Verlagerungszystozele a paravaginal Kolpopexie is displayed, in which the vagina is reattached to the lateral pelvic wall.