Cystocele is a condition where the wall between the bladder and the vagina weakens which leads to sagging of bladder into vagina. It is also known as anterior vaginal prolapsed.

The grades of cystocele are:

• Grade 1, mild: The bladder droops a short way into the vagina.
• Grade 2, more severe: The bladder has sunk into the vagina far enough to reach the opening of the vagina.
• Grade 3, most advanced: The bladder bulges out through the opening of the vagina.

CAUSES: Causes of cystocele includes:

• Aging
• Being overweight
• Childbirth
• Constipation / repeated straining during bowel movements
• Previous pelvic surgery
• Pelvic floor weakening
• The decline of estrogen during menopause

RISK FACTORS: These factors may increase your risk of anterior prolapse:

• Pregnancy and childbirth.Women who have had a vaginal or instrument-assisted delivery, multiple pregnancies, or whose infants had a high birth weight have a higher risk of anterior prolapse.
• Your risk of anterior prolapse increases as you age. This is especially true after menopause, when your body's production of estrogen — which helps keep the pelvic floor strong — decreases.
• Having your uterus removed may contribute to weakness in your pelvic floor, but this is not always the case.
• Some women are born with weaker connective tissues, making them more susceptible to anterior prolapse.
• Women who are overweight or obese are at higher risk of anterior prolapse.

SYMPTOMS

• A feeling of fullness or pressure in your pelvis and vagina
• In some cases, a bulge of tissue in your vagina that you can see or feel
• Increased pelvic pressure when you strain, cough, bear down or lift
• Problems urinating, including difficulty starting a urine stream, the feeling that you haven't completely emptied your bladder after urinating, feeling a frequent need to urinate or leaking urine (urinary incontinence)

MANAGEMENT:

Kegel exercise, which help strengthen pelvic floor muscles, may help lessen the symptoms. To do this exercise, you squeeze the muscles you use to control the flow of urine, hold for up to 10 seconds, then release. Aim to do at least three sets of ten repetitions a day for at least eight weeks.

HOMOEOPATHIC REMEDIES

Homoeopathy today is a rapidly growing system and is being practiced all over the world. It strength lies in its evident effectiveness as it takes a holistic approach towards the sick individual through promotion of inner balance at mental, emotional, spiritual and physical levels. When cystocele is concerned there are many effective medicines available in Homoeopathy, but the selection depends upon the individuality of the patient, considering mental and physical symptoms.

SEPIA: Highly effective medicine for Uterine Prolapse with constant bearing down sensation in the pelvic region. There is sensation as if the uterus is dragging in downward direction and is about to come out. Given when crossing the lower limbs may prove slightly helpful to decrease the bearing down sensation.There is vaginal discharge with itching .Best medicine for women at a menopausal age where the womb is in a relaxed condition with weak muscle support accompanied by hot flushes with excessive sweating.

LILIUM TIG: Effective medicine for prolapse of uterus who have constant urge to pass urine or stool with distended feeling in the pelvis. There is feeling of dragging sensation in the pelvis which is relief by supporting the vulva or taking rest.Useful where the muscle supporting the uterus lacks the required tonicity, resulting in a displaced (retroverted or uterus tilted backward) or a prolapsed uterus.

MUREX: Useful for prolapse of uterus where the uterus is bulky, enlarged and is pushed out of the pelvis. Very useful for bearing down feeling in the pelvis and need to tightly cross legs to prevent the bearing down sensation.Useful in decreasing the pain during periods due to a displaced uterus. Most suitable if the patient has an enhanced sexual desire.

FRAXINUS AMERICANA: Useful medicine for Uterine prolapse accompanied with fibroids or uterus tumors. There is bearing down pains which are always present in the pelvic region with enlarged uterus.