Cystocele

Classification according to ICD-10
N81.1	Cystocele
ICD-10 online (WHO version 2019)

Cystocele in a 73-year-old woman

A cystocele is a protrusion of the urinary bladder into the anterior vaginal wall . It occurs as a result of a weak pelvic floor , usually combined with a sagging or prolapse of the vagina . The urethra is usually included in the protrusion ( urethrocystocele ).

Clinical picture and diagnostics

A cystocele can cause urinary incontinence , and in larger cystoceles it can cause urinary retention .

During the vaginal examination with a speculum , the bladder floor is lowered and the anterior vaginal wall and the anterior vaginal vault bulge . Diagnosis is easier with a full bladder and abdominal press . In a cystourethrocele, the folds of the neck of the bladder and the waist of the bladder have disappeared, and the urethral bulge is no longer clearly delineated and pasty.

For the exact diagnosis and the correct treatment, it is crucial to distinguish whether it is a central or a lateral defect. In the case of a dilatation cystocele , the vaginal wall is smooth, whereas in a displacement cystocele , the vaginal wrinkles are preserved and only their lateral furrows are flattened or blurred. If these are lifted with a pair of tweezers and the cell disappears, then there is a lateral defect ( elevation test ).

treatment

Treatment is usually surgical. In the case of a stretch cystocele, an anterior vaginal plasty ( Kolporrhaphia anterior ) can be performed. In the case of a displacement cystocele, paravaginal colpopexy is indicated, in which the vagina is reattached to the lateral pelvic wall.

literature

Serban D. Costa: The gynecology . 2nd Edition. Springer, Berlin 2006, ISBN 978-3-540-25664-9 , pp. 212-222 .

Individual evidence

↑ Cystocele (Prolapsed Bladder) | NIDDK . In: National Institute of Diabetes and Digestive and Kidney Diseases . ( nih.gov [accessed December 2, 2017]).
^ Rizwan Hamid, Giovanni Losco: Pelvic Organ Prolapse-Associated Cystitis . In: Current Bladder Dysfunction Reports . tape 9 , no. 3 , September 1, 2014, ISSN 1931-7212 , p. 175–180 , doi : 10.1007 / s11884-014-0249-4 ( springer.com [accessed December 28, 2017]).

[1] Cystocele (Prolapsed Bladder) | NIDDK . In: National Institute of Diabetes and Digestive and Kidney Diseases . ( nih.gov [accessed December 2, 2017]).

[2] Rizwan Hamid, Giovanni Losco: Pelvic Organ Prolapse-Associated Cystitis . In: Current Bladder Dysfunction Reports . tape 9 , no. 3 , September 1, 2014, ISSN 1931-7212 , p. 175–180 , doi : 10.1007 / s11884-014-0249-4 ( springer.com [accessed December 28, 2017]).