Grade 3 Cystocele

A cystocele is a downward bulge of the bladder into the front wall of the vagina and hormone replacement treatment for cystocele may be applicable. A grade 3 cystocele occurs when the bladder bulges out through the opening of the vagina. In most cases, the type and degree of cystocele can be easily diagnosed by a physical examination.



Treatment

If your cystocele does not bother you then your doctor may recommend that you don't do any heavy lifting or straining that would cause your cystocele to worsen. If your cystocele bothers you somewhat, your doctor may recommend a pessary.

Pessary

A device that is inserted into the vagina to support the protruding bladder wall - is recommended. Pessaries are typically made of rubber or silicone and resemble a contraceptive diaphragm. The most common pessaries are shaped like a ring or doughnut in a variety of sizes. The pessary must be removed regularly for cleaning, which will help prevent vaginal discharge and pressure sores.

Surgery

However, for a grade 3 cystocele, surgery is most often required which would move the bladder back into a more normal position and keep it there. Surgery is done most often through the vagina, but it can also be done through the abdomen.

Hormone replacement therapy

Hormone replacement therapy (HRT) has been used to try to improve the tone and quality of the pelvic muscles and supportive tissues for cystoceles that appear after menopause. HRT may be used alone, with a pessary, or before and after surgery.

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