Two common forms of pelvic organ prolapse are bladder prolapse (cystocele) and urethral prolapse (urethrocele). A cystocele occurs when the wall of the
bladder presses against and moves the wall of the vagina. A urethrocele occurs
when the tissues surrounding the urethra sag downward into the vagina. Both
conditions are easy for your doctor to see during a physical exam. They often
occur at the same time and are usually caused by damage that happens when a
baby is delivered through the mother's birth canal (vagina).
While many women have some degree of bladder and urethral prolapse, few ever have any symptoms. Or the
symptoms do not appear for years. When symptoms do appear, they may include
difficulty urinating, involuntary release of urine (urinary incontinence), and pain during sexual
intercourse. Surgery is not required unless your symptoms interfere with daily
Unless another health problem is present that would
require an abdominal incision, the bladder and urethra are usually repaired
through an incision in the wall of the vagina. This surgery pulls together the
loose or torn tissue in the area of prolapse in the bladder or urethra and
strengthens the wall of the vagina. This prevents prolapse from recurring.
There are several types of surgery to correct stress urinary
incontinence. These surgeries lift the urethra and/or bladder into their normal
position. To learn more about these surgical procedures, see the topic
Urinary Incontinence in Women.
General anesthesia usually is used during repair of the bladder and urethra. You
may stay in the hospital from 1 to 2 days. You may go home with a catheter in
place. You can most likely return to your normal activities in about 6 weeks.
Avoid strenuous activity, such as heavy lifting or long periods of standing,
for the first 3 months, and increase your activity level gradually. Straining or lifting after you have resumed normal activities
may cause the problem to recur.
Most women are able to resume
sexual intercourse in less than 6 weeks. Urinary function usually returns to
normal in 2 to 6 weeks.
Why It Is Done
Repair of the bladder and urethra is
done to manage symptoms such as pressure on the vaginal wall from the movement
of those organs, difficulty urinating, urinary incontinence, and painful
intercourse. If you are experiencing involuntary release of urine (urinary
incontinence), further testing may be needed to find out what procedure is
Bladder and urethral prolapse often occur with the
prolapse of other pelvic organs, so tell your doctor about any other symptoms
you have. If your doctor finds a
rectocele, or small bowel prolapse (enterocele) during your routine pelvic examination,
that problem can also be repaired during surgery.
How Well It Works
Not much is known about how well the
surgery works over time. Some experts report that up to 20 out of 100 women
have another prolapse (recurrence) of the bladder or urethra after
Risks of cystocele and urethrocele repair
Formation of an abnormal connection or opening between two
What To Think About
Pelvic organ prolapse is often
caused or made worse by labor and vaginal delivery, so you may want to delay
surgical repair until you have finished having children.
repair may relieve some, but not all, of the problems caused by a cystocele or
urethrocele. If pelvic pain, low back pain, or pain with intercourse is present
before surgery, the pain may still occur after surgery. Symptoms of urinary
incontinence or retention may return or get worse following surgery.
You can control many of the activities that may have contributed to your
cystocele or urethrocele or made it worse. After surgery:
Stay at a healthy
weight for your height.
activities that put strain on the lower pelvic muscles, such as heavy lifting
or long periods of standing.