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Cystocele-Prolapsed Bladder

WHAT IS CYSTOCELE-PROLAPSED BLADDER?

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, or prolapsed bladder.

WHAT ARE THE SYMPTOMS OF CYSTOCELE-PROLAPSED BLADDER?

The symptoms of cystocele-prolapsed bladder may include:

  • Feeling of pelvic heaviness or fullness
  • Bulge in the vagina that you can feel
  • 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 bladder
  • Constipation
  • Needing to push organs back up into the vagina to empty the bladder or have a bowel movement
  • Pain during intercourse
  • Problems with tampons or vaginal applicators
  • Pelvic pressure that gets worse with standing, lifting or coughing or as the day goes on

WHAT CAUSES CYSTOCELE-PROLAPSED BLADDER?

Cystocele-prolapsed bladder may be caused by:

  • Pregnancy
  • Straining during childbirth
  • Chronic constipation
  • Straining during  bowel movements
  • Chronic coughing
  • Heavy lifting
  • Obesity

Cystocele-prolapsed bladder may develop or become more noticeable after menopause.

HOW IS CYSTOCELE-PROLAPSED BLADDER DIAGNOSED?

Cystocele-prolapsed bladder is diagnosed during a physical exam along with other medical tests, such as X-rays.

HOW IS CYSTOCELE-PROLAPSED BLADDER TREATED?

For many patients, cystocele surgery may be needed to repair the anterior vaginal wall. This may be combined with additional procedures to repair other points of pelvic organ support, such as anterior-posterior repair and anterior colporrhaphy.

The surgery chosen will depend on the cause and location of the patient’s cystocele-prolapsed bladder. It will also depend on the damage that exists between supporting structures and the vaginal wall. It may also be combined with more invasive surgeries, such as a hysterectomy.

Estrogen therapy is often administered prior to cystocele-prolapsed bladder surgery. Types of cystocele surgery include:

Colporrhaphy - One of the most common cystocele surgeries, colporrhaphy involves creating a stronger point of resistance to the intruding bladder wall. Surgical mesh is sometimes used to strengthen the anterior vaginal wall. 

Laparoscopic paravaginal defect repair - This surgery targets the ligaments and fascia through the abdomen. The lateral ligaments and supportive structures are repaired and sometimes shortened, which provides additional support to the vaginal wall.

Sacrocolpopexy - This procedure stabilizes the vaginal vault (the uppermost portion of the vagina). It is often chosen as the treatment for cystocele, especially if previous surgeries were not successful.

 

Colpocleisis - This cystocele surgery is designed to close the vaginal opening. It can be an option for women who no longer want to have vaginal intercourse.

If a prolapse of the rectum/colon is also present, the surgeon will take this concurrent condition into account while planning and performing the repairs. Cystocele surgery often accompanies the more invasive hysterectomy surgery.

There are also non-surgical treatments for cystocele-prolapsed bladder. Non-surgical treatments include:

  • Eating a high fiber diet
  • Pelvic floor exercises, such as Kegel exercises
  • Use of a pessary (a device inserted to support the vaginal wall)
  • Prescribed, intravaginal estrogen treatments to help prevent pelvic muscle atrophy

WHAT ARE THE COMPLICATIONS OF CYSTOCELE-PROLAPSED BLADDER?

Complications of cystocele-prolapsed bladder may include:

  • Difficulty urinating
  • Discomfort
  • Stress incontinence (laughing, coughing, sneezing or lifting heavy objects causes urine to leak)

WHO IS AT RISK FOR CYSTOCELE-PROLAPSED BLADDER?

People most at risk for cystocele-prolapsed bladder include:

  • Women who have given birth vaginally
  • Women in menopause, which weakens the pelvic floor as the body stops making estrogen
  • Women who have had a hysterectomy
  • Women who are genetically predisposed to having weaker connective tissues
  • Women who are obese

NEXT STEPS

Seek medical intervention. If you are experiencing symptoms of cystocele-prolapsed bladder, seek medical attention. To request an evaluation at Loma Linda University Health, contact your provider or schedule the appointment through MyChart.