What is a cystocele?

Normal Pelvis

Pelvis with a cystocele (fallen bladder)

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 three 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?

  • Feeling or seeing something bulging through the vaginal opening
  • Difficulty emptying the bladder (urinating)
  • Having to run to the bathroom frequently to pass water, or just a feeling as if you have to go a lot.
  • 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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