Information and Treatment for Bladder Prolapse (Cystocele)
What Is Bladder Prolapse (Cystocele)?
Normally, the bladder and other pelvic organs are supported by a complex of muscles, tendons and other tissues that make up the pelvic floor.
When the wall between the bladder and the vagina weakens, the bladder may drop or sag into the vagina. Cystocele also is called a prolapsed or “dropped” bladder.
Based on severity, cystoceles are graded 1-3. In severe cases, the bladder bulge can appear at the opening of the vagina, or even protrude through the opening.
What Causes a Cystocele?
Causes of cystoceles include:
- being overweight
- heavy lifting
- chronic coughing
- constipation/repeated straining during bowel movements
- previous pelvic surgery
- pelvic floor weakening
- the decline of estrogen during menopause
How Is a Cystocele Diagnosed?
Your health care professional will review your medical history and do a physical and pelvic exam. Other tests may include:
- a cystourethrogram, an X-ray of the bladder taken while you are urinating and with the bladder and urethra filled with contrast dye. It delineates the bladder and reveals any blockages.
- an MRI to determine the extent of bladder prolapse
Other tests may be needed to identify any other problems in the urinary system.
How Common Are Cystoceles?
Estimates are unreliable, because many women do not consult with their health care provider.
What Are the Common Symptoms of Cystoceles?
Symptoms of cystocele include:
- a feeling of heaviness or fullness in the pelvic area
- a bulge in the vagina that you can feel
- aching or a feeling of pressure in the lower belly
- lower back pain
- frequent urinary tract infections
- urinary incontinence/frequency/urgency
- incomplete emptying of the bladder
- needing to push organs back up into the vagina to empty the bladder or have a bowel movement
- pain during sex
- problems inserting tampons or vaginal applicators
- pelvic pressure that gets worse with standing, lifting, or coughing or as the day goes on
What Can I Do about a Cystocele?
Kegel exercises, which help strengthen pelvic floor muscles, may help lessen your symptoms. To do this exercise, you squeeze the muscles you use to control the flow of urine, hold for up to 10 seconds, then release. Aim to do at least three sets of ten repetitions a day for at least eight weeks.
If the dropped bladder becomes troublesome, affecting your quality of life, consult with your health care professional about treatment.
What Treatment Is Available for a Cystocele?
A cystocele can be managed medically, using:
- Kegel exercises, which help strengthen pelvic floor muscles
- pelvic floor physical therapy
- a pessary (a device inserted to support the bladder)
- estrogen replacement therapy
In some cases, surgery is necessary to move the bladder back into a more normal position. There are several approaches and techniques, which a urologist can discuss with you.
When Should I Make an Appointment with a Specialist?
If the dropped bladder becomes troublesome, affecting your quality of life, consult with your health care professional about treatment. The Women’s Medicine Collaborative has specialists who can help.