cystoceles

[lroberts]

I have a vaginal cystocele related to prolapsed bladder. My doctor seems to think there is nothing that can be done. He is sending me to a specialist, but I don't want that doctor to take the same attitude just because men don't have those problems, and don't think they are important.  I want to know if anyone out there has had a similar problem and what they have been told or what they are having done. I can't believe there isn't something that can be done that is effective. I am a nurse and don't think problems like this should be ignored and treated lightly.

[mykidzmama]

Have they performed an ultrasound or a laproscopy yet?  Do you know why you have a cystocele?  

If your uterus is tilted backwards and causing the pressure they could perform a partial hysterectomy, and remove it.  (At least they can in Ontario, Canada)  They could also tighten the vaginal wall or perform a reconstruction.  (I heard that the internal mesh used can cause serious problems though.)
http://www.vaginalmeshlawsuitcenter.us/vaginal-mesh/

http://www.theplasticsurgeryclinic.com/procedures/body/vaginaltightening/operation.html

There is also vaginoplasty using lasers.  I don't know anyone who has had that though.  http://www.drkarenboyle.com/vaginal_rejuvenation_vaginoplasty.html

[jmss4]

I'm sorry that your doctor was so discouraging.  From what I can tell, there is absolutely something that you can do for a cystocele.  I've been to two urogynecologists about my cystocele, rectocele, and perineal rectocele, and they each had different things to say about treatment.  One recommended surgery, acting as though such prolapses and procedures were totally commonplace; and the other recommended a pessary (a internal device, like a diaphragm, used to hold the prolapse in its proper place).  You can explore all of your options and find a urogynecologist nearest you at www.augs.org.  Hope this helps!

[pmsobx]

Here is some information on that for you.  I would find a doctor who specializes in pelvic floor reconstruction
OBJECTIVE: To evaluate mid term results, tolerance and efficiency of interposition of a tension-free polypropylene monofilament mesh by vaginal approach for the repair of cystoceles. PATIENTS AND METHODS: Fourty consecutive women underwent this new procedure between March 2001 and September 2002. After complete dissection of the cystocele, the polypropylene mesh (Gynemesh), Gynecare, Ethicon, Johnson & Johnson, France), proper cut-out was positioned under the bladder without any fixation. The lateral extensions of the mesh where introduced in the para-vesical spaces in contact with the arcus tendinus fascia pelvis. RESULTS: Before surgery all patients had cystocele of more or equal than grade II according to the POP-Q classification. Eight had grade II cystocele (20%) and 32 had grade III cystocele (80%). Thirty women had associated posterior or median prolapse (82.5%). Thirty women had urinary incontinence (75%). Mean age was 63.9 years (51-78). The procedure was performed without any difficulty in all cases. Duration of a cystocele cure procedure was 20 min +/- 2.2 (16-24). Mean follow-up is 16.4 months +/- 4.7 (12-24). The early complication rate was 7.5% (two vaginal erosions and one complete exposition of the mesh which requires secondary ablation). There was no mesh infection. The success rate was 95%. The satisfaction index overpasses 80% in 95% of our patients 6 months after the cystocele repair. DISCUSSION AND CONCLUSIONS: The interposition of a sub-vesical transversal tension-free polypropylene mesh by the vaginal route seems to be an excellent procedure in the definitive surgical treatment of grades II and III anterior vaginal wall prolapse. This new procedure is simple, mini-invasive, reproducible and efficient with low morbidity and good tolerance.


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