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Cystocele

What is a Cystocele?
 
Cystocele, sometimes called a prolapsed bladder, occurs when the vaginal wall that supports and maintains the bladder in its appropriate position weakens or is disrupted and allows the vaginal wall to protrude to varying degrees toward the vaginal opening. This can cause discomfort and/or problems with urine leakage or incomplete emptying of the bladder.
 
Types of Cystocele
 
Cystoceles can be categorized by many systems. One of those systems follows below. Its purpose is to describe the degree of vaginal wall prolapse.

  • Grade 1: The vagina is prolapsing but all within the vagina, and not near the vaginal opening.
  • Grade 2: The vaginal wall is protruding to the vaginal opening.
  • Grade 3: The vaginal wall is protruding beyond the vaginal opening.

Causes of Cystocele

A cystocele is caused by weakening of the supporting fibrous tissue in the wall between the bladder and vagina. This weakening can happen for a number of reasons, including pregnancy and vaginal birth, repeated straining during bowel movements/chronic constipation, heavy lifting or severe chronic coughing.

Diagnosis of Cystocele

Any cystocele can be diagnosed by a doctor through a physical examination, as the fallen part of the vagina is visible. Another test used to diagnose a cystocele is a voiding cystourethrogram, which is an X-ray of the bladder taken during urination.

Treatment of Cystocele

Most cystoceles do not require treatment, with doctors simply advising women to avoid any straining or heavy lifting that could cause the condition to worsen.

If a cystocele produces pain, discomfort, or problems with urination, options include:

  • Pessary: A device inserted into the vagina that helps reposition vaginal wall and bladder. Be aware of possible vaginal and urinary tract infections and see your doctor as directed if using this treatment.
  • Surgery: A Grade 2 or Grade 3 cystocele might need to be surgically repaired, if symptomatic, with the surgeon repairing the disrupted fibrous support tissue which reduces the amount of prolapsing vaginal wall moving the bladder to its normal position. To achieve this, the doctor makes an incision in the vaginal wall and restores the vaginal supportive structures to nearly the original condition tightens the layers of muscle in the wall between the organs.