Dear Dr N-
I have a cystocele, is this normal? What do I do about it? signed Droopy

Dear Droopy-
You are not alone, a cystocele is a weakening of the wall and connective tissue under the bladder so there is a bulge at the opening of the vaginal door. If it is mild, you cannot see or feel it. If it is severe it can come out the door. Mild cystoceles that do not interfere with bladder function are very common and respond well to weight control and Kegel exercises and or physical therapy. If it is really sagging we talk about a pessary or anterior colporrhaphy. I do not recommend use of the mesh for primary repairs unless you have a recurrent problem. This is something that should be individualized depending on your age, health, activity level and size of the problem. To further complicate things, there are rectoceles, vaginal apex prolapse and perineoceles! It is important to have the right diagnosis and the right repair. Hope that helps! If it is a definitive diagnosis and defect, there is pretty good insurance coverage. If is mild and women want correction to enhance sexuality, it is usually out of pocket I will further clarify after an exam. Dr N