Dr. Daniel Stone, MD FACOG
Urogynecologist located in Phoenix, AZ
Dr. Daniel Stone, MD is one of the leading experts in the surgical and non-surgical management of cystoceles and other forms of Pelvic Organ Prolapse. Dr. Stone can diagnosis and provides management options for cystoceles to patients in the Phoenix, Scottsdale and surrounding Arizona areas.
Cystocele Q & A
What is a Cystocele?
A cystocele refers to the dropping of the bladder into the vaginal canal. It is also called bladder prolapse and anterior vaginal wall prolapse. It is a subcategory of pelvic organ prolapse.
What are the symptoms of a Cystocele?Cystoceles can cause symptoms of vaginal bulge, vaginal pressure, and sensation of something falling out of the vagina. When a cystocele is more advanced the vaginal tissue can be felt or seen as it protrudes from the vaginal opening. These symptoms are commonly found in other forms of pelvic organ prolapse.Cystoceles can also cause urinary dysfunction, with different symptoms depending on the severity.
- Early-stage cystoceles: women will often have stress urinary incontinence, which is leakage with cough, laugh, or sneeze.
- Advanced-staged cystoceles:
- Overactive Bladder Symptoms - Urgency, frequency, nocturia, and Urge Urinary Incontinence.
- Incomplete bladder emptying - Due to this incomplete emptying, urinary tract infections can occur more frequently.
- Obstructive Nephropathy - The ureters, which are the tubes coming from the kidneys, can become backed up and dilated (hydronephrosis). This can eventually be life-threatening and can lead to kidney damage.
What are the causes of a Cystocele?
Ultimately a cystocele forms due to the loss of pelvic floor support. Like other forms of pelvic organ prolapse, cystoceles can have many different causes and risk factors including:
- Pregnancy, labor, or childbirth especially vaginal births or large babies.
- Aging and/or menopause
- Chronic cough
- Constipation and straining
- Repetitive heavy lifting
How is a Cystocele diagnosed?
Dr. Stone will first discuss your symptoms with you. He will then perform a physical exam including a gynecologic exam. This exam is slightly different than a normal gynecologic exam as he will take measurements as you push to see how far the cystocele comes down. Base on these measurements, he will then be able to give you a stage of the cystocele and show you diagrams of what your anatomy is doing.
Are other disorders commonly found with a Cystocele?
As mentioned earlier, a cystocele is a subcategory of pelvic organ prolapse. Other forms of pelvic organ prolapse are commonly found when someone has a cystocele, including a rectocele, uterine prolapse, and vaginal vault prolapse.
What are the conservative treatments for a Cystocele?
As long as you aren't having recurrent urinary tract infections, or kidney problems, a "watch and wait" strategy could be used. This is best used if your cystocele is not causing any bothersome symptoms.
You can also change your lifestyle and behaviors to minimize or lessen your symptoms. Some of these changes can also slow down the progression. These include:
- Avoid chronic straining by avoiding constipation and repetitive heavy lifting
- Keep your weight in a normal range and lose weight if you are overweight.
- Quit smoking
You can also perform pelvic floor muscle exercises (Kegels) to help improve mild prolapse symptoms. Dr. Stone can also refer you to a specialized physical therapist that specializes in this area.
A small silicone device called a pessary could also be used to manage a cystocele. A pessary can be inserted into the vagina to support the pelvic organs. Dr. Stone's office carries a variety of different shapes and sizes of pessaries and a fitting can be scheduled at your convenience.
What are the surgical treatments for a Cystocele?
The primary surgical repair is a cystocele repair. This repair is also called an anterior colporrhaphy or an anterior repair. Dr. Stone performs a cystocele repair vaginally under general anesthesia. He makes an incision along the vaginal wall and the vaginal skin is carefully dissected from the underlying supportive tissue. He then uses an absorbable suture to strengthen the tissue. The excess vaginal tissue is then trimmed and the skin is closed with suture.
It is also important that any loss of apical support is addressed with a cystocele repair. As mentioned previously, cystoceles often occur in the setting of vaginal vault prolapse or uterine prolapse. If these forms of prolapse are also present, then a sacrocolpopexy, hysteropexy or vaginal vault suspension should be performed at the same time.
Major Insurance Providers Accepted
We accept most insurance policies for your convenience. Please contact your insurance carrier to verify your individual benefits and any copays or coinsurance that are part of your plan. Patients are responsible for notifying our office if a specific plan requires precertification, preauthorization, or a referral (especially HMOs). Please call the phone number on the back of your insurance card to verify your provider network participation as insurance carriers change policies often.
Phoenix, Arizona 85016-1302
Office Hours: Monday-Friday from 8 AM – 5 PM
Main: (602) 788-1521
Fax: (602) 688-5420
Conveniently located just off Highway 51 on Maryland Avenue just East of 16TH Street between East Bethany Home Road and East Glendale Avenue.