Repair or not repair a cystocele and uterine prolapse.
was diagnosed with Grade 2 Cystocele and Rectocele grade 1-2 uterine
no sensation of heaviness, bulge etc.
was diagnosed with stress and urgency incontinence.
2 different board certified urogynecologists.
recommend the sling.
to use mesh to repair the prolapses but the other said if it is not
symptomatic, leave it alone.
if I have problems in the future, he would use my own tissue--not
would give me medication for urgency/frequency.
have any opinion about which approach (leaving prolapse alone- or
women with urine leakage can regain control by losing weight, cutting
caffeine or doing special pelvic muscle exercises called Kegel exercises,
exercises to strengthen the pelvic floor muscles. Kegel exercises
may also help relieve some symptoms of a cystocele (a type of pelvic
severe-grade 2-cystocele, the bladder sinks far enough to reach the
opening of the vagina.
A mechanical support device called a pessary (plastic or rubber ring
inserted into the vagina to support the bladder) helps some women.
options range from no treatment for a mild cystocele to surgery for
a serious cystocele.
cystocele is not bothersome, the doctor may only recommend avoiding
heavy lifting or straining that could cause the cystocele to worsen.
are moderately bothersome, the doctor may recommend a pessary- a device
placed in the vagina to hold the bladder in place.
come in a variety of shapes and sizes to allow the doctor to find
the most comfortable fit for the patient. Pessaries must be removed
regularly to avoid infection or ulcers.
is most often used for prolapse of the uterus (uterus droops or sags
into the vaginal canal because the muscles and ligaments that should
support it are weak).
can help if you have a cystocele (when your bladder droops down into
your vagina) or if you have a rectocele (when the wall of your rectum
bulges into the bottom of your vagina).
can also help many women who have stress urinary incontinence (the
leaking of urine when you cough, strain or exercise).
has to be fit just right in orderfor it work correctly and be comfortable.
vaginal pessaries can be worn during intercourse.
remain an excellent alternative to surgical repair for pelvic organ
prolapse and stress urinary incontinence.
pessary is indicated for use in adult women over 18 years of age who
experience involuntary urine loss with physical activity (stress incontinence),
but is not indicated for urge incontinence (also known as overactive
bladder) that is caused by bladder contractions (detrusor instability).
It is treated with bladder re-training, elimination of caffeine and
standard anticholinergic medications.
of a cystocele depends on how severe the cystocele is and whether
there are any related conditions, such as a uterus that slips into
the vaginal canal (prolapsed uterus).
Mild cases - those with few or no obvious symptoms - typically don't
require treatment. The patient could opt for a wait-and-see approach,
with occasional visits to the doctor to see if the prolapse is worsening,
along with self-care measures, such as exercises that strengthen pelvic
women use pessaries as a temporary alternative to surgery, and some
use them when surgery is too risky.
are noticeable, uncomfortable symptoms, the cystocele may require
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