Understanding Cystocele (Prolapsed Bladder)

Causes of a cystocele

A cystocele may be caused by:

• Heavy lifting.

• Straining muscles during childbirth.

• Chronic constipation.

• Repeated straining during bowel movements or with coughing.

• Weak muscles around the vagina caused by lack of estrogen after menopause.

• Obesity.

• Aging.

• Previous pelvic surgery.

Symptoms of a cystocele

Symptoms of a cystocele include:

• Leakage of urine when you cough, sneeze, or lift something heavy.

• Heavy, achy, or full feeling in the pelvis.

• Pelvic pressure that gets worse with standing, lifting, or coughing.

• A bulge in the vagina that you can feel.

• Lower back pain.

• Sexual difficulties.

• Problems with inserting tampons.

• Frequent urination or the urge to pass urine.

• Incomplete emptying of the bladder.

• Trouble starting a stream of urine.

Diagnosis of a cystocele

Your doctor will ask about your health history and give you a physical exam. Diagnosis may include looking in your bladder with a camera (cystoscopy), bladder function testing (urodynamics), X-rays, ultrasound, and MRI.

A cystocele is graded during diagnosis. Grade 1 means the bladder sags only a short way into the top of the vagina. Grade 2 means the bladder sags down to the lower opening of the vagina. Grade 3 means the bladder sags out of the lower opening of the vagina.

Treatment of a cystocele

Treatment depends on the grade of your cystocele and other factors. Your choices may include:

• Change of activity. You may need to not do certain activities, such as heavy lifting or straining. These can cause your cystocele to get worse.

• Pelvic floor exercises. These strengthen the muscles that support the bladder, uterus, and rectum.

• Pessary. This is a device put in the vagina to hold the bladder in place.

• Surgery. A procedure can be done to move the bladder back into a more normal position and hold it in place.