A cystocele, also known as a prolapsed bladder, is a form of pelvic organ prolapse where the bladder descends inferiorly and posteriorly into the vagina and perineum. It may be accompanied by prolapse of other pelvic organs.
CT / MRI
Sagittal images are particularly useful where the inferior margin of the bladder is often at a lower position than the pubococcygeal line . Imaging during strain is suggested to improve detection . Additional features that may be detected during dynamic pelvic floor MRI are changes in the urethral angle and involuntary loss of urine into the urethra during defecation.
Instillation of bladder contrast prior to a fluoroscopic pelvic floor study allows evaluation of bladder descent during evacuation.
Treatment and prognosis
A cystocele alone can be treated with a retropubic (Burch) colposuspension, which comprises the suspension of the lateral aspects of the bladder from the pelvic sidewalls. Once the fascia is detached from the tendinous arch, a paravaginal fascial repair is added .