When the wall between a woman’s
bladder and the vagina weakens, the bladder may drop or sag into the vagina. This
disorder is called a cystocele.
Cystoceles are grouped into grades:
Mild. The bladder droops only a short way into the vagina.
More severe. The bladder has sunk into the vagina far enough to reach the opening of the vagina.
Most advanced. The bladder bulges out through the opening of the vagina.
A cystocele may be caused by:
- Advancing age
- Child birth
- Heavy lifting
- Straining muscles during childbirth
- Chronic coughing
- Repeated straining during bowel movements
- Previous pelvic surgery
- Weak muscles around the vagina caused by lack of estrogen after menopause
Symptoms of cystocele include:
- Feeling of pelvic heaviness or
- Bulge in the vagina that you can
- Aching or a feeling of pressure in the
lower belly or pelvis
- Lower back pain
- Frequent urinary tract infections
- Need to urinate often or urgently
- Leakage of urine
- Incomplete emptying of the
- Needing to push organs back up into
the vagina to empty the bladder or have a bowel movement
- Pain during sex
- Problems putting in tampons or vaginal
- Pelvic pressure that gets worse with
standing, lifting, or coughing or as the day goes on
- Bleeding from the exposed skin
Your healthcare provider will review your medical history and do a physical and pelvic
exam. Other tests may include:
Cystourethrogram (voiding cystogram).
This is an X-ray of the bladder taken while the woman is urinating and with the
bladder and urethra filled with contrast dye. It shows the shape of the bladder and
Urodynamics. This is a test of
bladder function. It shows how much urine the bladder holds before causing an urge
void. It shows the cause of leaking urine.
MRI. This test can be used to
determine the extent of bladder prolapse.
Other tests may be needed to find out if there are any problems in the other areas
of the urinary system.
Treatment depends on the grade of the cystocele and may include:
Activity changes. Not doing certain
activities, such as heavy lifting or straining during bowel movements, that could
cause the cystocele to worsen.
Losing weight may reduce symptoms.
This may reduce symptoms of leaking and allow longer intervals between
Kegel exercises. Regular, daily
exercises of the pelvic muscles to make them stronger.
Pessary. This is a device placed in
the vagina to hold the bladder in place.
Surgery. May be used to move the
bladder back into a more normal position
Hormone replacement therapy. This may
help strengthen the muscles around the vagina and bladder. If you are thinking about
hormone replacement therapy, talk to your healthcare provider about the risks and
- A cystocele is when the wall between the bladder and the vagina weakens. This can
cause the bladder to drop or sag into the vagina.
- It may be caused by things that increase pressure on the pelvic muscles.
- Treatment depends on the severity of the cystocele. It may include avoiding certain
activities, surgery, or other methods.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also
know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that
- Know how you can contact your provider if you have questions.