Materiały źródłowe

• #1 Anterior vaginal prolapse (cystocele) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cystocele/symptoms-causes/syc-20369452

  Anterior vaginal prolapse, also known as a cystocele (SIS-toe-seel) or a prolapsed bladder, is when the bladder drops from its usual position in the pelvis and pushes on the wall of the vagina. […] Anterior prolapse is treatable. For a mild or moderate prolapse, nonsurgical treatment is often effective. In more severe cases, surgery may be necessary to keep the vagina and other pelvic organs in their proper positions. […] A prolapsed bladder can be uncomfortable, but it is rarely painful. It can make emptying your bladder difficult, which may lead to bladder infections. Make an appointment with your health care provider if you have any signs or symptoms that bother you or impact your daily activities. […] Anterior prolapse occurs when the pelvic floor becomes weak or if too much pressure is put on the pelvic floor. This can happen over time, during vaginal childbirth or with chronic constipation, violent coughing or heavy lifting.

• #1 Anterior vaginal prolapse (cystocele) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cystocele/diagnosis-treatment/drc-20369457

  Diagnosis of anterior prolapse may involve: […] A pelvic exam. You may be examined while lying down and possibly while standing up. During the exam, your provider looks for a tissue bulge into your vagina that indicates pelvic organ prolapse. […] Filling out a questionnaire. You may fill out a form that helps your provider assess your medical history, the degree of your prolapse and how much it affects your quality of life. […] Bladder and urine tests. If you have significant prolapse, you might be tested to see how well and completely your bladder empties. […] If you do have symptoms of anterior prolapse, first line treatment options include: […] A supportive device (pessary). A vaginal pessary is a plastic or rubber ring inserted into your vagina to support the bladder. […] If you still have noticeable, uncomfortable symptoms despite the treatment options above, you may need surgery to fix the prolapse. […] For anterior prolapse, some basic questions to ask include: […] Do I need any tests to confirm the diagnosis? […] What treatment approach do you recommend? […] What’s the likelihood that the anterior prolapse will recur after treatment?

• #1 Anterior vaginal prolapse (cystocele) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/anterior-vaginal-prolapse-cystocele

  Diagnosis of anterior prolapse may involve: […] A pelvic exam. You may be examined while lying down and possibly while standing up. During the exam, your provider looks for a tissue bulge into your vagina that indicates pelvic organ prolapse. You’ll likely be asked to bear down as if during a bowel movement to see how much that affects the degree of prolapse. To check the strength of your pelvic floor muscles, you’ll be asked to contract them, as if you’re trying to stop the stream of urine. […] Filling out a questionnaire. You may fill out a form that helps your provider assess your medical history, the degree of your prolapse and how much it affects your quality of life. This information also helps guide treatment decisions. […] Bladder and urine tests. If you have significant prolapse, you might be tested to see how well and completely your bladder empties. Your provider might also run a test on a urine sample to look for signs of a bladder infection, if it seems that you’re retaining more urine in your bladder than is normal after urinating.

• #1 Anterior and Posterior Vaginal Wall Prolapse – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/pelvic-organ-prolapse-pop/anterior-and-posterior-vaginal-wall-prolapse

  Anterior vaginal wall prolapse is commonly referred to as cystocele (protrusion of the bladder) or urethrocele (urethra). […] Diagnosis of vaginal wall prolapse is made clinically with pelvic examination by retracting the posterior vaginal wall and observing the anterior vaginal wall with the patient at rest and then with the patient straining. […] Cystocele is diagnosed by inserting a single-blade speculum in the vagina and retracting the posterior vaginal wall. Asking patients to strain makes cystoceles visible or palpable as soft reducible masses bulging into the anterior vaginal wall. […] Diagnose cystocele on pelvic examination by retracting the posterior vaginal wall and observing the anterior vaginal wall with the patient at rest and then with the patient straining.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosing-a-Cystocele.aspx

  Diagnosis of a cystocele begins with a careful history of symptoms as well as the medical and occupational history. […] An accurate diagnosis is fundamental for choosing the right method of treatment. […] A commonly used diagnostic classification of cystocele is that of the International Continence Society (ICS POP-Q), which uses only the degree of descent of the anterior vaginal wall. […] Thus in most patients, the clinical diagnosis is followed by imaging tests. […] Tests are then performed to assess the intensity of other symptoms and look for other signs. […] Ultrasound imaging is also used in order to visualize the position of the bladder and urethra, and their relationship with each other. […] Certain special tests are required if the woman has symptoms such as stress incontinence, and are directed at assessing the function of the bladder and urethra. […] Video cystourethrography or videourodynamics combines voiding cystourethrography with cystometrography, thus providing a simultaneous record of pressure and structural-functional measures within the bladder.

• #1 Pelvic organ prolapse | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/

  A prolapse is a common condition. […] Your doctor will need to carry out a pelvic examination, which will include an internal examination of your vagina. […] The internal examination is similar to a smear test and should only take a few minutes. […] The main types of prolapse are: anterior prolapse (cystocele) where the bladder bulges into the front wall of the vagina. […] A number system of 1 to 4 is usually used to describe how severe a pelvic organ prolapse is. […] Your doctor will discuss with you if they think any further tests are needed.

• #1 Cystocele – Wikipedia

  https://en.wikipedia.org/wiki/Cystocele

  Several scales exist to grade the severity of a cystocele. […] The pelvic organ prolapse quantification (POP-Q) assessment, developed in 1996, quantifies the descent of the cystocele into the vagina. […] The POP-Q provides reliable description of the support of the anterior, posterior and apical vaginal wall. […] Cystocele and prolapse of the vagina from other causes is staged using POP-Q criteria can range from good support (no descent into the vagina) reported as a POP-Q stage 0 or I to a POP-Q score of IV which includes prolapse beyond the hymen. […] The Baden-Walker Halfway Scoring System is used as the second most used system and assigns the classifications as mild (grade 1) when the bladder droops only a short way into the vagina; (grade 2) cystocele, the bladder sinks far enough to reach the opening of the vagina; and (grade 3) when the bladder bulges out through the opening of the vagina.

• #1 Anterior vaginal prolapse (cystocele) // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/anterior-vaginal-prolapse-cystocele

  Diagnosis of anterior prolapse may involve: […] A pelvic exam. You may be examined while lying down and possibly while standing up. During the exam, your provider looks for a tissue bulge into your vagina that indicates pelvic organ prolapse. […] Filling out a questionnaire. You may fill out a form that helps your provider assess your medical history, the degree of your prolapse and how much it affects your quality of life. […] Bladder and urine tests. If you have significant prolapse, you might be tested to see how well and completely your bladder empties. Your provider might also run a test on a urine sample to look for signs of a bladder infection, if it seems that you’re retaining more urine in your bladder than is normal after urinating.

• #1 Cystocele – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/cystocele

  How do health care professionals diagnose a cystocele? To diagnose a cystocele, health care professionals ask about your symptoms and medical history and perform a physical exam, including a pelvic exam to check your lower abdomen. You may be asked to stand during part of the exam, which may feel awkward but allows your health care professional to determine the severity of your cystocele. Your health care professional may also order medical tests to determine how advanced the cystocele is or to help find or rule out other problems in your urinary tract or pelvis. […] If you are having trouble completely emptying your bladder or experience other lower urinary tract symptoms, your health care professional may use one or more of the following tests to look at your urinary tract. Postvoid residual urine measurement determines how much urine is left in your bladder after urination. Voiding cystourethrogram uses x-rays to show how urine flows through the bladder and urethra.

• #1 Vaginal Prolapse: Symptoms, Treatment, Causes, and More

  https://www.healthline.com/health/womens-health/vaginal-prolapse

  Vaginal prolapse can be diagnosed through a pelvic exam. During the exam, your doctor might ask you to bear down as if you’re trying to push out a bowel movement. […] Your doctor might also ask you to tighten and release the muscles you’d use to stop and start the flow of urine. This test checks the strength of the muscles that support your vagina, uterus, and other pelvic organs. […] If you have problems urinating, you may have tests to check your bladder function. This is called urodynamic testing. […] Uroflowmetry measures the amount and strength of your urine stream. […] Cystometrogram determines how full your bladder needs to get before you have to go to the bathroom. […] Your doctor might also do one or more of these imaging tests to look for problems with your pelvic organs:

• #1 Pelvic organ prolapse – a review

  https://www.racgp.org.au/afp/2015/july/pelvic-organ-prolapse-a-review

  This is performed by translabial ultrasonography, using abdominal curved array transducers placed in a mid-sagittal orientation on the perineum. The severity of FPOP is quantified against the symphyseal margin. Defaecation proctography has been the gold standard in the investigation of defaecatory symptoms but ultrasonography is better tolerated and cheaper, and can replace radiological techniques in the initial investigation of these women. […] Direct imaging of the levator is facilitated by 3D/4D ultrasonography, enabling diagnosis of avulsion and hiatal ballooning simply and non-invasively in an examination that takes, at most, 10 minutes and requires no preparation. As a result, it has become possible to define the likelihood of recurrence after conventional reconstructive surgery, allowing better counselling of patients and surgical planning.

• #1 Vaginal Prolapse: Symptoms, Treatment, Causes, and More

  https://www.healthline.com/health/womens-health/vaginal-prolapse

  Pelvic ultrasound. This test uses sound waves to check your bladder and other organs. […] Pelvic floor MRI. This test uses strong magnets and radio waves to make pictures of your pelvic organs. […] CT scan of your abdomen and pelvis. This test uses an X-ray to create detailed pictures of your pelvic organs.

• #1 Cystocele (Prolapsed Bladder): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15468-cystocele-fallen-bladder

  A cystocele occurs when the ligaments and muscles that hold up your bladder stretch or weaken. […] A healthcare provider who specializes in the female reproductive and urinary systems (urologist or gynecologist) can diagnose a cystocele. Theyll review your medical history, ask questions about your symptoms and conduct a physical examination. […] The provider may also perform the following tests: Urodynamic testing. This test measures your bladders ability to hold and release pee. […] Cystoscopy. A healthcare provider passes a long, pencil-sized lighted tube with a camera on the end (cystoscope) through your urethra to your bladder. Theyll look for malformations, blockages, tumors or stones in your urinary tract. […] If you have cystocele symptoms, see a healthcare provider immediately.

• #1 Pelvic Organ (Vaginal) Prolapse | Melbourne Bladder Clinic

  https://bladderclinic.com.au/conditions/female-pelvic-medicine/pelvic-organ-vaginal-prolapse

  A physical examination is essential in making a diagnosis. This is always done with care and consideration, in the presence of a female chaperone if needed. You may be asked to bear down to show the prolapse. […] A urodynamics study (bladder function test) is sometimes used to assess for any other bladder storage or voiding problems. Incontinence can sometimes be masked by a prolapse and you may be asked to cough and bear down to look for leakage with and without the prolapse being pushed back. This will help the surgeon decide whether an incontinence surgery has to be done at the same time as the prolapse surgery. […] A cystoscopy (look inside the bladder with a tubelike camera) is sometimes done, especially if the patient also complains of the frequent need to urinate, blood in the urine or bladder pain.

• #1 Pelvic Organ Prolapse: Practice Essentials, Background, Problem

  https://emedicine.medscape.com/article/276259-overview

  Pelvic organ prolapse is the abnormal descent or herniation of the pelvic organs from their normal attachment sites or their normal position in the pelvis. The pelvic structures that may be involved include the uterus (uterine prolapse) or vaginal apex (apical vaginal prolapse), anterior vagina (cystocele), or posterior vagina (rectocele). […] The following laboratory studies may be needed: Urine sample, clean midstream; Measurement of blood urea nitrogen (BUN), creatinine, glucose, and calcium levels; Urine cytology. […] If the uterus is to be preserved, ultrasonographic imaging is strongly recommended. […] When the patient has significant anterior vaginal wall prolapse (cystocele), it is important to exclude the development of postoperative potential incontinence (PI) prior to management of pelvic organ prolapse.

• #1 Pelvic Organ Prolapse » Department of Urology » College of Medicine » University of Florida

  https://urology.ufl.edu/patient-care/female-urology-reconstuctive-surgery/conditions/

  Anterior vaginal wall prolapse: is descent of the top of the vagina. It is often referred to as a cystocele or the bladder dropping as the bladder is located anterior to or on top of the vagina. […] Diagnosis: History and physical examination: used to review symptoms and their impact on quality of life. Risk factors, medical history, and surgical history are also reviewed. […] Cough/Valsalva stress test: is performed at the time of a pelvic examination. The patient may be asked to strain or cough to look for any signs of urinary incontinence. […] Urodyanmic study: is a bladder study which gives the physician important information about how your bladder is storing and emptying urine.

• #1 Pelvic Organ Prolapse: Practice Essentials, Background, Problem

  https://emedicine.medscape.com/article/276259-overview

  To test for potential incontinence, a cystometrogram is performed, and the bladder is retrograde filled to maximum capacity (or at least 300 mL) with sterile water or saline while the pelvic organ prolapse is replaced and elevated digitally or with an appropriately fitted pessary. […] This approach of performing adequate testing (urodynamics) prior to management of pelvic organ prolapse (especially during sacrocolpopexy surgery) is supported by several studies. […] However, other authors have challenged the accuracy and predictability of urodynamics prior to open sacrocolpopexy (Colpopexy and Urinary Reduction Efforts [CARE] trial) and advocated a prophylactic Burch colposuspension be performed concomitantly with sacrocolpopexy to reduce postoperative development of stress urinary incontinence.

• #1 Diagnosis and management of pelvic organ prolapse: The basics – Women’s Healthcare

  https://www.npwomenshealthcare.com/diagnosis-management-pelvic-organ-prolapse-basics/

  Differential diagnoses to consider when assessing a woman for POP include adnexal, uterine, and other genital tract masses that may cause symptoms similar to those of POP; and urinary tract infection (UTI). […] Treatment for POP is based on severity of the prolapse and the patients preferences, health, and symptoms. […] If POP is grade 2 or lower, PFM strengthening, including Kegel exercises, can improve symptoms of pelvic pain, vaginal pressure or bulging, and SUI. […] The pessary, a flexible plastic or medical-grade silicone device that comes in a variety of sizes and shapes, can be used to treat any grade of POP. […] Surgery is an option for a woman whose symptoms are adversely affecting her quality of life. Several different surgical procedures are available. Colporrhaphy is done to repair the anterior or posterior vaginal wall in a woman with cystocele or rectocele.

• #1 Cystocele – Wikipedia

  https://en.wikipedia.org/wiki/Cystocele

  A cystocele, also known as a prolapsed bladder, is a medical condition in which a woman’s bladder bulges into her vagina. […] Diagnosis is often based on symptoms and examination. […] The initial assessment of cystocele can include a pelvic exam to evaluate leakage of urine when the women is asked to bear down or give a strong cough (Valsalva maneuver), and the anterior vaginal wall measured and evaluated for the appearance of a cystocele. […] If a woman has difficulty emptying her bladder, the clinician may measure the amount of urine left in the woman’s bladder after she urinates called the postvoid residual. […] A voiding cystourethrogram involves taking X-rays of the bladder during urination. […] Differential diagnosis will be improved by identifying possible inflammation of the Skene’s glands and Bartholin glands.

• #1 Pelvic organ prolapse in women: Surgical repair of anterior vaginal wall prolapse – UpToDate

  https://www.uptodate.com/contents/pelvic-organ-prolapse-in-women-surgical-repair-of-anterior-vaginal-wall-prolapse

  Anterior vaginal wall prolapse describes support abnormalities of the anterior wall of the vagina. Prolapse of the anterior wall typically coexists with prolapse at other anatomic sites (vaginal apex, posterior vaginal wall). The prevailing view is that a common pathogenesis underlies support defects at different sites of the vaginal wall, replacing a previous focus on isolated anatomic compartments. Procedures for surgical repair of anterior vaginal wall defects should include repair of apical prolapse, if present. […] Pelvic organ prolapse (POP) affects millions of women; approximately 200,000 inpatient surgical procedures for prolapse are performed annually in the United States. Eleven to 19 percent of women will undergo surgery for prolapse or urinary incontinence by age 80 to 85 years, and 30 percent of these women will require an additional prolapse or incontinence surgery. […] Reconstructive procedures for prolapse of the anterior vaginal wall are reviewed here. Related topics regarding POP in women are discussed separately, including: Diagnosis and evaluation and conservative management.

• #1 Cystocele (Prolapsed Bladder): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15468-cystocele-fallen-bladder

  A moderate or severe cystocele may require an anterior colporrhaphy. An anterior colporrhaphy is a type of reconstructive surgery in which a surgeon moves your bladder back into its normal position and tightens the muscles in the front wall that hold your bladder in place. […] A cystocele can get worse without treatment. In the worst cases, you may not be able to pee, which can cause an infection or damage your kidneys.

• #1 Pelvic Prolapse: Diagnosing and Treating Cystoceles, Rectoceles, and Enteroceles – Page 4

  https://www.medscape.com/viewarticle/722323_4

  Simply defined, a cystocele is a protrusion of the bladder into the vagina due to defects in pelvic support. The radiographic definition of a cystocele is descent of the bladder base below the inferior margin of the symphysis pubis. […] In most cases, the type and degree of cystocele are easily determined by physical examination. At times, however, an extensive vaginal prolapse may prevent accurate determination of the presence and stage of a cystocele, or a physical exam can not be easily obtained. In such circumstances, an upright resting and straining cystogram can be helpful in determining the presence and degree of cystocele. […] The mere presence of a cystocele is not necessarily symptomatic, although the loss of anterior vaginal support usually includes a loss of support to the bladder neck, commonly manifested by stress urinary incontinence during activity.

• #1 Pelvic Prolapse: Diagnosing and Treating Cystoceles, Rectoceles, and Enteroceles – Page 4

  https://www.medscape.com/viewarticle/722323_4

  Asymptomatic patients with grade 1 or 2 cystoceles isolated do not usually require treatment; however, patients with grade 3 and especially grade 4 cystoceles typically require treatment due to debilitating symptoms, regardless of other associated conditions. […] We recommend a urodynamic evaluation for all patients with grade 3 and grade 4 cystoceles. […] Patients with a central defect are best treated by anterior colporrhaphy, which reapproximates the pubocervical fascia in the midline. […] Long-term results are difficult to compare among various reported series due to significant differences in technique, definitions of failure, indications for the procedure, and simultaneous performance of other procedures, which may affect postoperative outcome in a positive or negative fashion. […] Lateral defects require a different approach in which the vaginal attachments to the pelvic sidewall are reconstituted. […] An alternative approach, which also treats the lateral defect and stress incontinence, is the 4-corner bladder-neck suspension.

• #1 Types of Vaginal Prolapse

  https://www.contemporaryobgyn.net/view/types-vaginal-prolapse

  If there is a break in the pubocervical fascia anywhere throughout its length or at its attachment to the arcus tendineus it will result in a lack of support of the bladder or urethra. A break in the pubocervical fascia (support system) can be in the middle of the fascia (midline defect), apically (where anterior vaginal wall meets the cervix) or laterally (paravaginal defect). […] Surgical correction of cystocele and urethrocele depend upon the specific area of break: Midline defects – site specific repair or anterior repair (colporrhaphy) Paravaginal defects – paravaginal repair (MOST COMMON) Transverse defects – site specific repair. […] Cystocele midline or central defect – (side view) – This patient has a cystocele due to a midline or central defect on the pubocervical fascia (support system). Now the bladder is sagging in the area lacking fascia. To repair this area an anterior repair should be performed to specifically correct the pubocervical fascia defect.

• #1 ACOG/AUGS Guidance Update: Diagnosis and Management of Pelvic Organ Prolapse Including Role of Mesh – The ObG Project

  https://www.obgproject.com/2019/10/28/acog-augs-guidance-update-diagnosis-and-management-of-pelvic-organ-prolapse-including-role-of-mesh/

  ACOG and AUGS have updated the Pelvic Organ Prolapse (POP) recommendations. Guidelines now address the FDA order for manufacturers to discontinue sale and distribution of mesh for treatment of POP in the US. […] The POP-Q system is recommended before treatment of POP to quantify the degree of prolapse. […] Anterior wall prolapse is commonly associated with apical prolapse. […] Both should be surgically corrected if present to reduce risk of recurrent POP. […] Biologic grafts show minimal/ no difference in recurrence risk vs native tissue repair. […] Synthetic mesh improves anatomic outcome, but is associated with increased risk of repeat surgery for prolapse, urinary incontinence and mesh exposure. […] 11% risk of mesh erosion following anterior vaginal repair. […] 7% of cases that will require surgical correction. […] Dyspareunia rate of approximately 9%. […] Use of mesh or biologic grafts should only be undertaken by surgeons who have training specific for these procedures. […] Routine intraoperative cystoscopy should be performed during POP surgery when there is risk to the bladder or ureter.

• #1 How to Self-Check for Pelvic Organ Prolapse

  https://www.theoriginway.com/blog/how-to-self-check-for-pelvic-organ-prolapse-and-what-to-do-next

  Pelvic organ prolapse occurs when the muscles and connective tissues in your pelvic floor including those surrounding your vagina become too damaged and weak to support your pelvic organs, causing an organ (or part of an organ) to drop down into the vaginal canal or rectum. […] Anterior Prolapse describes the displacement of organs from the front of the vaginal vault and may include the bladder (cystocele), the urethra (urethrocele), or both (cystourethrocele). […] If you think you might have pelvic organ prolapse or have already been diagnosed and want to start feeling better see a pelvic floor physical therapist sooner rather than later. […] Physical therapy treatment for vaginal or pelvic organ prolapse usually involves assessing and optimizing the performance of your pelvic floor, hip, and abdominal muscles.

• #1 Pelvic Organ Prolapse | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0801/p179.html

  The most common complications of pessary use are vaginal discharge, irritation, ulceration, bleeding, pain, and odor. […] Primary care physicians should feel comfortable with screening for prolapse, performing a basic evaluation, and, depending on training, pessary management. […] Obliterative and reconstructive surgeries for pelvic organ prolapse are available and may include hysterectomy or uterine conservation (hysteropexy).

• #1 Urology & Continence Care Today | May 2025

  https://www.ucc-today.com/journals/issue/launch-edition/article/pelvic-organ-prolapse-and-female-urinary-incontinence-assessment-ucct

  Pelvic organ prolapse (POP) has been defined by Haylen et al (2016) as the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix) or the apex of the vagina (vaginal vault or cuff scar after hysterectomy). […] The skill of the person assessing the patient is vital, as getting as much accurate information as possible during the consultation helps the correct diagnosis and treatment plan to be made. […] It is essential that a thorough assessment is undertaken when examining a woman presenting with POP or urinary symptoms. […] Thorough assessment of symptoms of POP and urinary incontinence is essential to ensure that the correct diagnosis is made, and appropriate treatment pathways are started, or referral made to secondary care.

• #2 Cystocele (Prolapsed Bladder): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15468-cystocele-fallen-bladder

  A cystocele occurs when the ligaments and muscles that hold up your bladder stretch or weaken. […] A healthcare provider who specializes in the female reproductive and urinary systems (urologist or gynecologist) can diagnose a cystocele. Theyll review your medical history, ask questions about your symptoms and conduct a physical examination. […] The provider may also perform the following tests: Urodynamic testing. This test measures your bladders ability to hold and release pee. […] Cystoscopy. A healthcare provider passes a long, pencil-sized lighted tube with a camera on the end (cystoscope) through your urethra to your bladder. Theyll look for malformations, blockages, tumors or stones in your urinary tract. […] If you have cystocele symptoms, see a healthcare provider immediately.

• #2 Anterior vaginal prolapse (cystocele) | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/anterior-vaginal-prolapse-cystocele

  Diagnosis of anterior prolapse may involve: […] A pelvic exam. You may be examined while lying down and possibly while standing up. During the exam, your provider looks for a tissue bulge into your vagina that indicates pelvic organ prolapse. You’ll likely be asked to bear down as if during a bowel movement to see how much that affects the degree of prolapse. To check the strength of your pelvic floor muscles, you’ll be asked to contract them, as if you’re trying to stop the stream of urine. […] Filling out a questionnaire. You may fill out a form that helps your provider assess your medical history, the degree of your prolapse and how much it affects your quality of life. This information also helps guide treatment decisions. […] Bladder and urine tests. If you have significant prolapse, you might be tested to see how well and completely your bladder empties. Your provider might also run a test on a urine sample to look for signs of a bladder infection, if it seems that you’re retaining more urine in your bladder than is normal after urinating.

• #2 Cystocele – Alaska Urology

  https://www.alaskaurology.com/womens-health/cystocele/

  Diagnosis of anterior prolapse may involve: […] A pelvic exam. You may be examined while lying down and while standing up. During the exam, your doctor looks for a tissue bulge into your vagina that indicates pelvic organ prolapse. You’ll likely be asked to bear down as if during a bowel movement to see how much that affects the degree of prolapse. To check the strength of your pelvic floor muscles, you’ll be asked to contract them, as if you’re trying to stop the stream of urine. […] Filling out a questionnaire. You may fill out a form that helps your doctor assess the degree of your prolapse and how much it affects your quality of life. Information gathered also helps guide treatment decisions. […] Bladder and urine tests. If you have significant prolapse, you might be tested to see how well and completely your bladder empties. Your doctor might also run a test on a urine sample to look for signs of a bladder infection, if it seems that you’re retaining more urine in your bladder than is normal after urinating.

• #2 Bladder Prolapse (Cystocele) – Midwest Center for Pelvic Health

  https://www.midwestpelvis.com/bladder-prolapse-cystocele/

  Cystocele is the term used to describe what is happening when the front wall of the vagina bulges down toward the opening of the vagina. […] The diagnosis of cystocele is made with the help of a pelvic exam by a trained physician or other medical provider. […] During this exam, your doctor may ask you to bear down, push, or cough to re-create some of your symptoms. […] Dr. Stewart will often use all or part of a speculum during the exam. This allows him to hold certain walls of the vagina in place while evaluating the movement of others. This helps him to localize the pelvic organ prolapse and develop a customized treatment plan to suit your particular variety of pelvic organ prolapse cystocele or otherwise. […] Given this information and the findings of your examination of the pelvis, doctor Stewart will sit with you and explain the exam findings, often drawing pictures, and allowing you to ask questions about all of the various treatments available.

• #2 Cystocele – Wikipedia

  https://en.wikipedia.org/wiki/Cystocele

  Several scales exist to grade the severity of a cystocele. […] The pelvic organ prolapse quantification (POP-Q) assessment, developed in 1996, quantifies the descent of the cystocele into the vagina. […] The POP-Q provides reliable description of the support of the anterior, posterior and apical vaginal wall. […] Cystocele and prolapse of the vagina from other causes is staged using POP-Q criteria can range from good support (no descent into the vagina) reported as a POP-Q stage 0 or I to a POP-Q score of IV which includes prolapse beyond the hymen. […] The Baden-Walker Halfway Scoring System is used as the second most used system and assigns the classifications as mild (grade 1) when the bladder droops only a short way into the vagina; (grade 2) cystocele, the bladder sinks far enough to reach the opening of the vagina; and (grade 3) when the bladder bulges out through the opening of the vagina.

• #2 Diagnosis and management of pelvic organ prolapse: The basics – Women’s Healthcare

  https://www.npwomenshealthcare.com/diagnosis-management-pelvic-organ-prolapse-basics/

  Pelvic organ prolapse (POP) is a prevalent condition that can cause uncomfortable sensations of vaginal bulging, painful intercourse, and even stress urinary incontinence. This article presents a simple, evidence-based approach to diagnosing and managing POP that womens healthcare providers can implement. […] The healthcare provider (HCP) must take a thorough history regarding these symptoms, as well as a detailed gynecologic, obstetric, sexual, and surgical history, to determine contributing factors. […] Because many patients have more than one type of prolapse, the HCP needs to examine each area of potential involvement within the vaginal vault separately. Performing each component of the pelvic exam with an individual focus results in greater accuracy of diagnosis. […] Various grading systems are available to determine the severity of POP based on physical examination. In this article, the authors use the Baden-Walker Halfway Scoring System, which assigns these gradations of severity: Grade 0: no prolapse; Grade 1: the lowest part of protrusion extends halfway to the hymen; Grade 2: the lowest part of protrusion extends to the hymen; Grade 3: the lowest part of protrusion extends halfway past the hymen; or Grade 4: the greatest degree of protrusion is observed.

• #2 Anterior vaginal prolapse (cystocele) // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/anterior-vaginal-prolapse-cystocele

  Diagnosis of anterior prolapse may involve: […] A pelvic exam. You may be examined while lying down and possibly while standing up. During the exam, your provider looks for a tissue bulge into your vagina that indicates pelvic organ prolapse. […] Filling out a questionnaire. You may fill out a form that helps your provider assess your medical history, the degree of your prolapse and how much it affects your quality of life. […] Bladder and urine tests. If you have significant prolapse, you might be tested to see how well and completely your bladder empties. Your provider might also run a test on a urine sample to look for signs of a bladder infection, if it seems that you’re retaining more urine in your bladder than is normal after urinating.

• #2 Anterior prolapse (cystocele) – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/anterior-prolapse-cystocele/

  Bladder and urine tests. If you have significant prolapse, you might be tested to see how well and completely your bladder empties. Your doctor might also run a test on a urine sample to look for signs of a bladder infection, if it seems that you’re retaining more urine in your bladder than is normal after urinating.

• #2 Pelvic organ prolapse | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/vulva-vagina/pelvic-organ-prolapse

  Prolapse is usually diagnosed via a clinical examination. Your doctor will ask about your medical history and do a pelvic examination, and other tests if required. […] The pelvic examination will determine: the severity of the prolapse, how well the pelvic floor muscles are functioning, which organs are part of the prolapse. […] You may need other tests. For example: a pelvic ultrasound to check for any masses or cysts in the pelvic area, assessment of bladder function (urodynamic studies) to check for different types of incontinence, a bladder ultrasound to see if wee isn’t emptying completely from the bladder after going to the toilet, a mid-stream urine test to rule out infection if there are bladder symptoms.

• #2 Pelvic Organ Prolapse – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563229/

  A urodynamic evaluation is recommended to assess bladder and sphincteric function if the patient has significant voiding symptoms. […] The compartment of descent additionally dictates treatment. […] A variety of procedures, both abdominal and vaginal, are performed in an attempt to restore the pelvic floor function and relieve symptoms. […] The procedure with an anatomic success rate of 98% and a subjective success rate of 93% is an obliterative procedure known as colpoclesis in which the vaginal cuff is shortened. […] Adequate support of the vaginal apex has been recognized as an essential component of an adequate surgical repair for advanced prolapse. […] The advantages of transvaginal approaches include shorter operative and recovery times, whereas the advantages of abdominal approaches provide more durable outcomes and decrease the risk of recurrence.

• #2 Cystocele Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/womens-health/cystocele-fallen-bladder/diagnosis.html

  In addition to a complete medical history and physical examination (which may reveal the fallen part of the bladder through the vagina), diagnostic procedures for a cystocele may include a cystourethrogram (also called a voiding cystogram). This is an X-ray of the bladder during urination and with the bladder and urethra filled with contrast medium to determine the shape of the bladder and any obstructions. […] Other tests and procedures may be necessary to determine if there are any problems in the other areas of the urinary system.

• #2 Vaginal Prolapse: Symptoms, Treatment, Causes, and More

  https://www.healthline.com/health/womens-health/vaginal-prolapse

  Pelvic ultrasound. This test uses sound waves to check your bladder and other organs. […] Pelvic floor MRI. This test uses strong magnets and radio waves to make pictures of your pelvic organs. […] CT scan of your abdomen and pelvis. This test uses an X-ray to create detailed pictures of your pelvic organs.

• #2 Pelvic Organ (Vaginal) Prolapse | Melbourne Bladder Clinic

  https://bladderclinic.com.au/conditions/female-pelvic-medicine/pelvic-organ-vaginal-prolapse

  A physical examination is essential in making a diagnosis. This is always done with care and consideration, in the presence of a female chaperone if needed. You may be asked to bear down to show the prolapse. […] A urodynamics study (bladder function test) is sometimes used to assess for any other bladder storage or voiding problems. Incontinence can sometimes be masked by a prolapse and you may be asked to cough and bear down to look for leakage with and without the prolapse being pushed back. This will help the surgeon decide whether an incontinence surgery has to be done at the same time as the prolapse surgery. […] A cystoscopy (look inside the bladder with a tubelike camera) is sometimes done, especially if the patient also complains of the frequent need to urinate, blood in the urine or bladder pain.

• #2 Pelvic Organ Prolapse: Practice Essentials, Background, Problem

  https://emedicine.medscape.com/article/276259-overview

  To test for potential incontinence, a cystometrogram is performed, and the bladder is retrograde filled to maximum capacity (or at least 300 mL) with sterile water or saline while the pelvic organ prolapse is replaced and elevated digitally or with an appropriately fitted pessary. […] This approach of performing adequate testing (urodynamics) prior to management of pelvic organ prolapse (especially during sacrocolpopexy surgery) is supported by several studies. […] However, other authors have challenged the accuracy and predictability of urodynamics prior to open sacrocolpopexy (Colpopexy and Urinary Reduction Efforts [CARE] trial) and advocated a prophylactic Burch colposuspension be performed concomitantly with sacrocolpopexy to reduce postoperative development of stress urinary incontinence.

• #2 Pelvic Organ Prolapse: Practice Essentials, Background, Problem

  https://emedicine.medscape.com/article/276259-overview

  A thorough preoperative assessment can prevent many postoperative complications. […] Each patient underwent preoperative prolapse reduction testing using a pessary. This test was found to have high sensitivity, specificity, and positive predictive value for the postoperative cure of urinary retention.

• #2 Anterior Vaginal Prolapse (Cystocele) – Coyle Institute

  https://coyleinstitute.com/cystocele/

  When the wall between the bladder and the vagina weakens, the bladder may drop or sag into the vaginal wall. This disorder, which can happen to women of any age, is called a cystocele or anterior vaginal wall prolapse. […] Rather than tolerating the symptoms of a cystocele, it is important to receive a definitive diagnosis and be treated to avoid further complications. […] To accurately diagnose a cystocele, your provider at Coyle Institute will review your medical history and perform a physical and pelvic exam. Other tests may include: Urodynamics, Cystoscopy, Urine tests, Bladder scans, MRI.

• #2 Pelvic Organ Prolapse: Types, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/24046-pelvic-organ-prolapse

  Your treatment plan will depend on how severe the prolapse is, where it is and how much your symptoms affect you. […] There are surgical and nonsurgical treatment options. […] Surgery may be an option if your symptoms don’t improve with conservative treatments or if your provider believes surgery gives you the best quality of life moving forward. […] There isn’t one specific stage that requires surgery to treat a pelvic organ prolapse. […] It’s typically more common to need surgery if you have a third or fourth stage prolapse. […] With mild POP, you can strengthen your muscles so that they hold the organs in their correct locations. […] Reconstructive surgeries strengthen the weaknesses in your pelvic walls so that your organs return to their original locations.

• #2 Pelvic Prolapse: Diagnosing and Treating Cystoceles, Rectoceles, and Enteroceles – Page 4

  https://www.medscape.com/viewarticle/722323_4

  Asymptomatic patients with grade 1 or 2 cystoceles isolated do not usually require treatment; however, patients with grade 3 and especially grade 4 cystoceles typically require treatment due to debilitating symptoms, regardless of other associated conditions. […] We recommend a urodynamic evaluation for all patients with grade 3 and grade 4 cystoceles. […] Patients with a central defect are best treated by anterior colporrhaphy, which reapproximates the pubocervical fascia in the midline. […] Long-term results are difficult to compare among various reported series due to significant differences in technique, definitions of failure, indications for the procedure, and simultaneous performance of other procedures, which may affect postoperative outcome in a positive or negative fashion. […] Lateral defects require a different approach in which the vaginal attachments to the pelvic sidewall are reconstituted. […] An alternative approach, which also treats the lateral defect and stress incontinence, is the 4-corner bladder-neck suspension.

• #2 Types of Vaginal Prolapse

  https://www.contemporaryobgyn.net/view/types-vaginal-prolapse

  Cystocele (Midline Defect) – Vaginal View – here the skin has been pulled back to demonstrate the hole or defect in the pubocervical fascia (supportive layer). The defect in the supportive layer allows the bladder to come in direct contact with the vaginal skin resulting in a cystocele. […] Paravaginal (lateral) defect – resulting in a cystocele (aerial view).

• #2 Anterior vaginal prolapse (cystocele) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cystocele/symptoms-causes/syc-20369452

  Anterior vaginal prolapse, also known as a cystocele (SIS-toe-seel) or a prolapsed bladder, is when the bladder drops from its usual position in the pelvis and pushes on the wall of the vagina. […] Anterior prolapse is treatable. For a mild or moderate prolapse, nonsurgical treatment is often effective. In more severe cases, surgery may be necessary to keep the vagina and other pelvic organs in their proper positions. […] A prolapsed bladder can be uncomfortable, but it is rarely painful. It can make emptying your bladder difficult, which may lead to bladder infections. Make an appointment with your health care provider if you have any signs or symptoms that bother you or impact your daily activities. […] Anterior prolapse occurs when the pelvic floor becomes weak or if too much pressure is put on the pelvic floor. This can happen over time, during vaginal childbirth or with chronic constipation, violent coughing or heavy lifting.

• #2 Pelvic Organ Prolapse | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0801/p179.html

  Complex urodynamic testing performed while reducing the prolapse with swabs or a speculum may help predict which women will benefit from a concomitant anti-incontinence procedure. […] The primary goal of any treatment is to improve symptoms and, for conservative management, to minimize prolapse progression. […] Most cases of pelvic organ prolapse do not require treatment; however, women with prolapse beyond the vaginal opening typically desire some intervention. […] Pelvic floor muscle training has been shown to improve symptoms associated with stress, urge, and mixed urinary incontinence and may result in a small improvement in symptoms in women with mild prolapse. However, it does not reverse or treat pelvic organ prolapse. […] Pessaries are devices that are placed in the vagina to restore normal pelvic anatomy and decrease prolapse symptoms.

• #2 Cystocele – NIDDK

  https://www.niddk.nih.gov/health-information/urologic-diseases/cystocele

  Your health care professional may consider surgery to treat a cystocele if nonsurgical treatments don’t work or your cystocele is severe. The most common surgical procedure to repair a cystocele is anterior vaginal repair, also called anterior colporrhaphy. During this procedure, a surgeon puts the bladder back in its normal position and tightens the muscles and tissues that hold the bladder in place using stitches.

• #2 ACOG/AUGS Guidance Update: Diagnosis and Management of Pelvic Organ Prolapse Including Role of Mesh – The ObG Project

  https://www.obgproject.com/2019/10/28/acog-augs-guidance-update-diagnosis-and-management-of-pelvic-organ-prolapse-including-role-of-mesh/

  ACOG and AUGS have updated the Pelvic Organ Prolapse (POP) recommendations. Guidelines now address the FDA order for manufacturers to discontinue sale and distribution of mesh for treatment of POP in the US. […] The POP-Q system is recommended before treatment of POP to quantify the degree of prolapse. […] Anterior wall prolapse is commonly associated with apical prolapse. […] Both should be surgically corrected if present to reduce risk of recurrent POP. […] Biologic grafts show minimal/ no difference in recurrence risk vs native tissue repair. […] Synthetic mesh improves anatomic outcome, but is associated with increased risk of repeat surgery for prolapse, urinary incontinence and mesh exposure. […] 11% risk of mesh erosion following anterior vaginal repair. […] 7% of cases that will require surgical correction. […] Dyspareunia rate of approximately 9%. […] Use of mesh or biologic grafts should only be undertaken by surgeons who have training specific for these procedures. […] Routine intraoperative cystoscopy should be performed during POP surgery when there is risk to the bladder or ureter.

• #2 Bladder prolapse (cystocele) | healthdirect

  https://www.healthdirect.gov.au/bladder-prolapse

  Bladder prolapse (also called a cystocele) is when your bladder bulges into your vaginal wall. The term 'prolapse’ means 'to fall out of place’. […] Your doctor will ask about your symptoms and medical history. They will examine you and, with your consent, perform an internal examination. This can help your doctor find out if you have a bladder prolapse and how severe it is. […] Your doctor may refer you for some tests, including: an ultrasound scan of your pelvis, a bladder function (urodynamic) test for incontinence, a urine test to check for infection. […] They may also refer you to a specialist doctor this may be a gynaecologist or urologist.

• #2 Diagnosis and management of pelvic organ prolapse: The basics – Women’s Healthcare

  https://www.npwomenshealthcare.com/diagnosis-management-pelvic-organ-prolapse-basics/

  If conservative management is desired and the grade of POP is 2 or lower, HCPs should counsel patients with regard to performing Kegel exercises and on behavior modification strategies, which include weight loss; smoking cessation; and avoidance of straining with bowel movements, prolonged standing, lifting, and exercise involving jumping. […] Need for referral depends on the plan for POP management and the HCPs skills in diagnosing and managing the condition.

• #3 Mayo Clinic Health Library – Anterior vaginal prolapse (cystocele) | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20369433

  Anterior vaginal prolapse, also known as a cystocele (SIS-toe-seel) or a prolapsed bladder, is when the bladder drops from its usual position in the pelvis and pushes on the wall of the vagina. […] Diagnosis of anterior prolapse may involve: […] A pelvic exam. You may be examined while lying down and possibly while standing up. During the exam, your provider looks for a tissue bulge into your vagina that indicates pelvic organ prolapse. […] Filling out a questionnaire. You may fill out a form that helps your provider assess your medical history, the degree of your prolapse and how much it affects your quality of life. […] Bladder and urine tests. If you have significant prolapse, you might be tested to see how well and completely your bladder empties. Your provider might also run a test on a urine sample to look for signs of a bladder infection, if it seems that you’re retaining more urine in your bladder than is normal after urinating.

• #3 Vaginal Prolapse: Symptoms, Treatment, Causes, and More

  https://www.healthline.com/health/womens-health/vaginal-prolapse

  Vaginal prolapse can be diagnosed through a pelvic exam. During the exam, your doctor might ask you to bear down as if you’re trying to push out a bowel movement. […] Your doctor might also ask you to tighten and release the muscles you’d use to stop and start the flow of urine. This test checks the strength of the muscles that support your vagina, uterus, and other pelvic organs. […] If you have problems urinating, you may have tests to check your bladder function. This is called urodynamic testing. […] Uroflowmetry measures the amount and strength of your urine stream. […] Cystometrogram determines how full your bladder needs to get before you have to go to the bathroom. […] Your doctor might also do one or more of these imaging tests to look for problems with your pelvic organs:

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