What is a cystocele?

A cystocele, sometimes called a prolapsed bladder, happens when the supportive tissues between the bladder and vagina become weak or stretched. This allows the bladder to move downward and press into the vaginal wall.

The condition can range from mild to more advanced. Some women have few symptoms, while others notice pressure, urinary problems, or a bulge in the vagina that affects daily activities.

Several factors can weaken the pelvic floor and increase the risk of cystocele, including:

• Pregnancy and vaginal childbirth
• Aging
• Menopause and lower estrogen levels
• Excess body weight
• Chronic coughing
• Repeated heavy lifting
• Constipation and frequent straining
• Previous pelvic surgery

Symptoms

A cystocele can develop slowly over time. Symptoms may become more noticeable after standing for long periods, lifting heavy objects, or physical activity.

Common symptoms include:

• A feeling of pressure or heaviness in the pelvis
• A bulge or fullness in the vagina
• Leaking urine
• Frequent urination or sudden urges to urinate
• Trouble fully emptying the bladder
• Recurrent urinary tract infections
• Lower back discomfort
• Constipation or straining during bowel movements
• Discomfort during sexual activity

How is it diagnosed?

Healthcare providers diagnose a cystocele by reviewing symptoms and performing a pelvic exam. During the exam, you may be asked to cough or bear down to help evaluate how much the bladder has shifted.

Additional testing may be recommended if urinary symptoms are severe or if more information is needed. These tests can include bladder function studies, imaging tests, or evaluations for other pelvic floor conditions.

How is it treated?

Treatment depends on the severity of symptoms and how much the prolapse affects daily life. Many women improve with conservative treatments that strengthen pelvic support and reduce pressure on the bladder.

Non-surgical treatments may include:

• Pelvic floor exercises, including Kegels
• Pelvic floor physical therapy
• Weight management
• Avoiding heavy lifting and straining
• Bladder training techniques
• A pessary device placed in the vagina to support the bladder

For some postmenopausal women, estrogen therapy may help improve vaginal tissue strength.

If symptoms are more advanced or do not improve with conservative care, surgery may be recommended to restore support to the bladder and surrounding tissues. Recovery time depends on the type of procedure performed, but many patients gradually return to normal activities over several weeks.