Urological Disorders

Cystocele (fallen bladder)

What is a cystocele?

Cystocele is the name for a hernia-like disorder in women that occurs when the wall between the bladder and the vagina weakens, causing the bladder to drop or sag into the vagina.

What are the results of a cystocele?

In addition to discomfort, the resulting dropped bladder can cause two kinds of problems to occur:

unwanted urine leakage
incomplete emptying of the bladder

The dropped bladder stretches the opening into the urethra, and urine may leak when a woman:

coughs
sneezes
laughs
or does any action that puts pressure on the bladder

What are the grades of cystoceles?

grade 1 - mild - when the bladder droops only a short way into the vagina
grade 2 - more severe - when the bladder has sunk into the vagina far enough to reach the opening of the vagina
grade 3- most advanced - when the bladder bulges out through the opening of the vagina

What causes a cystocele?

A cystocele may result from:

muscle straining while giving birth
heavy lifting
repeated straining during bowel movements
menopause - The hormone estrogen helps keep the muscles around the vagina strong, but with menopause, the body stops making estrogen and the muscles around the vagina and bladder may become weakened.

How is a cystocele diagnosed?

Grade 2 or grade 3 cystoceles may be diagnosed from a description of symptoms and from physical examination of the vagina. The fallen part of the bladder will be visible.

A cystourethrogram, a test that involves taking x-rays of the bladder during urination, shows the shape of the bladder and any problems that might block the normal flow of urine.

Other x-rays and tests may be needed to find or rule out problems in other parts of the urinary system.

What are possible treatment options for cystoceles?

A treatment recommendation will be made by your physician depending upon the severity of your condition. Some common treatment options for cystoceles include:

activity modification (i.e. avoiding heavy lifting or straining that could cause the cystocele to worsen)
a pessary - a device placed in the vagina to hold the bladder in place
surgery - to move the bladder back into a more normal position and keep it there
estrogen replacement therapy - may help to strengthen the muscles around the vagina and bladder

This page was last updated on: February 28, 2008.

For more information, call the University Physicians Consultation and Referral Service at 1-800-492-5538 (patients) or 1-800-373-4111 (physicians).