What is a cystocele?

Normal Pelvis

A cystocele ― also known as a prolapsed, herniated, dropped, or fallen bladder (where your urine or “water” is stored) ― occurs when ligaments that hold your bladder up and the muscle between a woman’s vagina and bladder stretches or weakens, allowing the bladder to sag into the vagina.

There are 3 grades of cystocele:

  • Grade 1 (mild): The bladder drops only a short way into the vagina.
  • Grade 2 (moderate): The bladder drops to the opening of the vagina.
  • Grade 3 (severe): The bladder bulges through the opening of the vagina.

What causes a cystocele?

Risk factors for a cystocele include:

  • Vaginal births, which may involve straining the muscles of the floor of the pelvis.
  • Family history.
  • Obesity.
  • Intense physical activity, including lifting heavy objects.
  • Hysterectomy.
  • Constipation and/or repeated muscle straining during bowel movements.
  • Frequent coughing.
  • Aging and a drop in the hormone estrogen. Estrogen helps keep muscles around the vagina strong, but women produce less estrogen as they enter menopause (the end of menstrual periods).

What are the symptoms of a cystocele?

  • Having to run to the bathroom frequently to pass water, or just a feeling as if you have to go a lot.
  • Unwanted leakage of urine (incontinence). The fallen bladder may stretch the opening of the urethra (the tube through which urine passes). This can cause urine to leak out during coughing, sneezing, laughing, or moving in a way that puts pressure on the bladder.
  • Incomplete emptying of the bladder.
  • Frequent urinary tract infections.
  • Feeling of fullness, heaviness, or pain in the pelvic area or lower back. This feeling may get worse when the person is standing, lifting, coughing, or as the day goes on.
  • The bladder bulging into or out of the vagina.
  • Painful sex.
  • Problems inserting tampons or applicators.

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