What is a cystocele?

A cystocele (pronounced sis-toe-seel) is also called an anterior prolapse, dropped or prolapsed bladder. It often occurs because the wall between the vagina and bladder has been torn or weakened during childbirth allowing the bladder to bulge or drop into the vaginal vault. Other less common causes can be severe obesity, straining regularly because of chronic constipation, violent coughing or even lifting heavy things incorrectly.

As with all types of prolapse, the effects can range from mild to severe and may need treatment or not, depending on whether or not it is affecting a woman’s quality of life or health.

A mild cystocele (grade 1) might not even be noticed by some women and may only be diagnosed when a nurse or doctor is doing a pelvic examination. In these cases strengthening exercises for the abdominal muscles and pelvic region may be recommended. Alongside avoiding getting constipated and heavy lifting Kegel and pelvic floor exercises can often be enough to prevent the prolapse from worsening. The most common symptoms are a feeling of heaviness in the abdominal region and pain or leaking during sex.

A severe cystocele (grade 2 or 3) is where the fallen bladder is noticeable to the woman, perhaps even protruding from the vagina and between the labia (folds of skin around the bladder). In such cases women may find it uncomfortable to sit or stand for long periods of time, they may have difficulty fully emptying their bladder and have recurring urinary tract infections.

Cystocele treatment

Self management is often recommended for mild cases, with regular monitoring by your GP. Learning how to do the Kegel exercises correctly and undertaking exercise designed to strengthen your core abdominal muscles will be helpful in all cases of prolapse.

Vaginal pessaries may be recommended if the cystocele is advanced. These are designed to hold everything in place and are often used while waiting for surgery or if surgery can’t be performed for other reasons. Clear guidance will be given on how to look after them to prevent infections occurring.

Oestrogen only hormone replacement therapy may be prescribed to help your muscles retain their strength, which naturally declines after the menopause.

Surgery is common for severe cystocele cases and involves stitching the bladder back at the same time as tightening the ligaments that support abdominal organs of the pelvic region. It may be performed at the same time as a hysterectomy if there are other complications such as fibroids or uterine prolapse.

(Image: Courtesy of http://scientia.wikispaces.com/Pelvis+Viscera+-+Lecture+Notes)

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  1. I had a full abdominal hysterectomy 4 months ago – i had a stage 3-4 prolapse which my doctor said would be resolved after surgery. My prolpase has returned and I am devasted as I am still recoverng from my hysterectomy. I wonder is this sue to my weight? or that I didnt do my exercises properly after the surgery? or the menopause? I am at a loss as I don’t want to go through another operation. Thank you

  2. I had my Prolapse repair over a year ago. I still feel sore and the doctor said ive got a slight bulge again… This is such a nasty problem to have i never feel normal there.. Also i started having pain in my left side, the doctor felt inside and went very quiet told me she thinks it is not the same as the right side up there… So have to go for a internal scan they hurt.. Just want all the pain to stop…

  3. this is true I had a total abdominal Hysterectomy tubes and ovaries incl
    I bounced back and was back at work in 3 1/2 weeks
    albeit I only push a mouse around all day and answer phones
    but I never felt better and 2 years on don’t regret a thing
    but the lady who was in the same day as me for same operation we kept in touch and she was still recovering 9 months later.
    you never know your recovery time until it happens
    positive attitude and good support is necessary

  4. Could u please help my daughter has been suffering sever pain on left side of tummy when doc dipped the urine it said urine infection when sent to lab said there was no infection she’s on a long term antibiotic she said that she feels a pushing down feeling she has been attending the doc for some time she’s had her bladder stretched I’m really worried because this has been going on a long time my daughter is age 38 could this pain be coming from the womb?

  5. I had a vaginal repair two years ago and pelvic clearance for endometrial cancer 4 years ago and now feel as if I am developing another prolapse is this possible I think my gynaecologist will laugh at me when I go for my annual review. I don’t know what a prolapse looks like? Please help!

  6. Hi Glenys. The reason you can’t find times is because there are no hard and fast rules about recovery. It depends on your health before the op, the type of op you have, why you are having it and what you do for yourself to help your recovery. It could be as quick as 4/6 weeks or as long as 10/12.

  7. I am due to have a Vaginal hysterectomy as my bladder and uterus have prolapsed. I don’t seem to be able to find recovery times for this procedure. Can you help and give information on this subject. Would be much appreciated.
    Thank you