What Are the Possible Causes of an Enlarged Bladder?

Cystocele

Overview of cystocele

Cystocele

cystocele

A type of female reproductive system injury, the bladder bulges towards the anterior vaginal wall. The most common cause is damage to the pelvic floor fascia and muscles that keeps the bladder in a normal position without a timely repair. In severe cases, the urethra also bulges. Those who are mild are asymptomatic, and often suffer from backache falling in severe cases, consciously have something come out of the vagina, and the mass will shrink after urination. Often accompanied by difficulty urinating and feeling unclean. It is often accompanied by tension urinary incontinence, that is, when the abdominal pressure increases, such as coughing, there may be urine overflow when exerting force, postmenopausal symptoms increase. Inserting a metal urethral catheter into the urethra confirms that the bulging part is the bladder. No treatment is needed for mild cases, and anterior vaginal wall repair is available for severe cases. At the same time, chronic chronic increase in abdominal pressure, such as chronic cough and asthma, must be corrected.

Causes of cystocele

The supporting tissue of the anterior vaginal wall is mainly the pubic bladder cervical fascia. When the fetal head passes through the vagina during delivery, the pubic bladder, cervical fascia, and pubic coccyx muscles are inevitably extremely stretched and even torn. If the rest is not good before the puerperium, especially if you engage in physical work too early, you will support the vagina Tissue can not return to normal or close to normal, causing the bladder to lose support and bulge to the vaginal wall, which is called cystocele; weak front part of the fascia can produce urethral bulge.

Identification of cystocele

(1) Tumors of the front wall of the vagina The tumors can make the front wall of the vagina prominent, much like vaginal prolapse with bladder bulge. During the gynecological examination, the mass can be felt as cystic or solid, with a certain degree of tension, the boundary of the mass is clear, does not increase with the increase of abdominal pressure, and it is not easy to be returned to the vagina. Bladder bulge is soft with no clear borders and increases with increasing abdominal pressure. It can be returned to its original position when pushed by hand. When a metal catheter is inserted into the bladder for examination, the catheter cannot enter the mass.

(2) Uterine prolapse often has a feeling of vulva or vaginal bulge, something protrudes from the vagina, aggravates during prolonged standing and work, and the symptoms disappear when bed rest. In the gynecological examination, the outer cervix can be seen in the center of the lower end of the extract, and the probe can be probed into the uterine cavity through this hole. The urinary bladder bulges above the protrusions to reach the cervix, and the uterus is in the normal position.

(C) tension urinary incontinence The disease and bladder bulge have similar symptoms, but the pathogenesis of the two is completely different, and they can coexist. During cystourethrography, tension urinary incontinence manifests as disappearance of the posterior angle of the urethra, and the tilt angle of the urethra is greater than normal. When the bladder bulges, the tilt angle of the urethra and the posterior angle of the urethra are within the normal range.

(4) Hymenia atresia is asymptomatic in the early stage, periodic lower abdominal pain occurs after puberty, and urinary retention can occur. Gynecological examination showed that the hymen was swollen and purple-blue. An anal digital examination has a tense cystic mass in front of the rectum.

Clinical manifestations of cystocele

Those who are mild can be asymptomatic, or have a slight feeling of falling, backache, aggravation after standing for a long time, and shrink after bed rest. In addition to falling sensation, they often have difficulty urinating, and often have more residual urine, and more often have urinary tract infections. If the sphincter in the urethra also relaxes, it can increase abdominal pressure in cases of laughter, cough, and force. , There is urine overflow, said tension urinary incontinence.

Diagnosis and differential diagnosis of cystocele

Mainly rely on vaginal inspection and palpation. At the time of inspection, the vaginal opening was wide, with old perineal lacerations. Vaginal opening protrusions may increase when you hold your breath. At palpation, the prominent mass was anterior vaginal wall, soft and unclear. If a metal catheter is inserted into the urethral bladder, the metal catheter is touched in the shrinkable mass, which can be diagnosed as a bladder or urethral bulge, and the possibility of other masses in the vagina, such as submucosal uterine fibroids, vagina Wall cysts, vaginal bowel hernias, hypertrophic cervix and uterine prolapse (coexisting).

Cystocele

Degree means that the bulging bladder is still in the vagina, which is lower than the normal anatomical part; Degree means that the bulging part of the bladder is exposed outside the vaginal opening when the force is applied;

degree means that the bladder bulge is exposed outside the vaginal opening when it is stationary;

IV degree means that the anterior wall of the vagina completely bulges beyond the vaginal opening, even beyond the labia majora.

Bladder prevention

Delivery should be handled properly. Those who do not have a pelvic basin should have a cesarean section as early as possible; the mother should not hold her breath down when the uterine orifice is fully open; Prolonged; if there is a perineal tear, it should be repaired immediately; avoid premature participation in physical labor after childbirth, and post-natal health exercises help restore the pelvic floor muscles and fascia tension.