Pelvic Floor Problems

Cystocele: When the bladder drops from its normal place into the vagina, it is called a cystocele. Typical symptoms are of a "preassure" in the vagina. Some cystoceles cause urine leakage when you cough, sneeze, lift objects, or even walk. Large cystoceles may kink the urethra and interfere with the passing of urine. If this occurs, you may have to strain or push the bladder up by reaching into the vagina in order to pass urine. If there is a very large cystocele and if the bladder loses some of its ability to contract, it may not completely empty.

Small cystoceles are common. They usually do not interfere with urination and do not need surgery. If a cystocele is causing symptoms, your doctor can suggest ways to relieve them.

The place where the bladder joins the urethra is called the bladder outlet or bladder neck. When the tissues that support the bladder neck are damaged, it may drop and push against the vaginal wall. A dropped bladder neck is called a cystourethrocele. It may cause urine to leak. Urine is more likely to leak when there is a sudden increase in abdominal pressure caused by walking, jumping, coughing, sneezing, laughing, lifting, or making sudden movements. The amount of urine lost may be only a few drops, or it may be enough to require changing clothes or wearing pads.

You should tell your doctor if you cannot control the leakage of urine. Sometimes leakage is not caused by a cystourethrocele. It may be due to urinary tract infection, bladder problems, or to other medical conditions, which are not corrected by surgery.

Enterocele: When the intestine bulges into the upper vagina, it forms an enterocele. In order to diagnose an enterocele, a doctor may have to place a finger in the vagina and a finger in the rectum while you are standing

Rectocele: When the rectum bulges into or out of the vagina, it is called a rectocele. It is caused by a weakness of the back wall of the vagina. A large rectocele may make it very hard to have a bowel movement, especially if you have constipation. Some women have to push the bulge back into the vagina in order to complete a bowel movement.

Uterine Prolapse: When the uterus drops down into the vagina, it is called uterine prolapse. The distance the uterus drops may vary. Mild degrees of prolapse are common. It often does not cause symptoms and does not need surgery. Women with more severe forms of this condition often