Back

Cystocele/Rectocele

(Pelvic Relaxation; Bladder Prolapse; Fallen Bladder/Rectocoele; Protruding Rectum)

Definition

Connective tissue separates the pelvic organs. The tissue, called fascia, is attached to nearby muscles. The fascia and muscles support the bladder, vagina, and rectum. Defects in the fascia can cause cystoceles and rectoceles.
In a cystocele, there is a defect in the fascia between the bladder and vagina. This allows a part of the bladder wall to bulge into the vagina. There are three grades of cystocele:
Cystocele
si55551974 96472 1
Copyright © Nucleus Medical Media, Inc.
In a rectocele, there is a defect in the fascia between the rectum and the vagina. This allows part of the wall of the rectum to bulge into the vagina.
Rectocele
si55551976 96472 1
Copyright © Nucleus Medical Media, Inc.
The sooner that a cystocele or rectocele is treated, the better the outcome. If you suspect you have this condition, contact your doctor.

Causes

The walls between the vagina and bladder or rectum can be damaged by one or more of the following factors:

Risk Factors

Postmenopausal women are at increased risk.
Factors that increase your risk for a cystocele or rectocele include:

Symptoms

Many cases are mild and do not have symptoms.
In more serious cases, the symptoms of cystocele include:
Symptoms of rectocele include:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. You may also have a vaginal and rectal exam. Tests for cystocele may include the following:
You may need to have images taken of your urine and bowel activity. This can be done with:
Your bodily fluid may need to be tested. This can be done with urine tests.

Treatment

Talk with your doctor about the best plan for you. For the mildest cases of cystocele and rectocele, no treatment is needed. For more serious cases, treatment options include the following:

Activity Modification

  • Your doctor may suggest that you avoid heavy lifting.
  • Kegel exercises, which involve squeezing the pelvic floor muscles, may help to strengthen the muscles around the vagina and bladder.
  • A diet that allows for easy passage of stools may help with a rectocele. The diet should include fiber, liquids, and a stool softener if advised.

Pessary

A pessary is a device that is inserted into the vagina. It can provide support to keep the bladder and/or rectum in place.

Estrogen Replacement Therapy

Adding estrogen may help strengthen the walls of the vagina after menopause . It may be delivered in the form of pills, creams, or patches.

Surgery

For severe cases, surgery may be needed to move the bladder or rectum back into place.

Prevention

To help reduce your chances of getting cystocele and rectocele, take the following steps:

RESOURCES

American Society of Colon and Rectal Surgeons http://www.fascrs.org

Urology Care Foundation http://www.urologyhealth.org

CANADIAN RESOURCES

Canadian Urological Association http://www.cua.org

Women's Health Matters http://www.womenshealthmatters.ca

References

Cystocele (fallen bladder). National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://www.kidney.niddk.nih.gov/kudiseases/pubs/cystocele. Updated March 26, 2014. Accessed October 27, 2014.

A healthy pregnancy for women with diabetes. The American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq176.pdf?dmc=1&ts=20130301T1642555353. Published December 2011. Accessed October 27, 2014.

Pelvic organ prolapse. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 20, 2014. Accessed October 27, 2014.

Rectocele. American Society of Colon and Rectal Surgeons website. Available at: http://www.fascrs.org/patients/conditions/rectocele. Updated October 2012. Accessed October 27, 2014.

Revision Information