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Cystocele and Urethrocele

(also known as Anterior Vaginal Wall Prolapse)

Cystocele (bladder prolapse) and Urethrocele (urethra prolapse) are two forms of pelvic organ prolapse caused by a loss of support in the anterior vaginal wall. The anterior vaginal wall supportive layer is called the pubocervical fascia. Anterior vaginal wall relaxation is one of the most commonly diagnosed forms of pelvic organ prolapse in women. Anterior vaginal wall is named based upon its two ends of attachment. Anterior vaginal wall is attached distally to the pubic bone area and proximally to the cervix if the uterus has not been removed. The pubocervical fascia is also attached laterally (on both sides) to the pelvic floor muscles specifically the obturator internus muscle. As long as this vaginal wall stays in place the bladder and urethra will stay in its normal anatomical position.

Normal Cystocele Side
Non-Cystocele Side View

Cystocele Side View

Symptoms of cystocele, urethrocele, or cystourethrocele

  • Pelvic/Vaginal pressure
  • Dyspareunia (painful intercourse)
  • Dragging or drawing vaginal sensation
  • Urinary incontinence
  • Difficulty emptying bladder
  • Repositioning body to empty bladder

Surgical Repair for Cystocele/Urethrcoele

Surgical correction of cystocele and urethrocele depend upon the specific area of break:

  • Anterior Repair (Colporrhaphy) or Site Specific Repair, repairs a Midline Defect
  • Laparoscopic Paravaginal Repair (MOST COMMON) or Paravaginal Repair with Burch Urethropexy will repair a paravaginal defect
  • Any other site specific repair is for a transverse defect

Surgical Techniques utilized by Dr. Miklos and Dr. Moore


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