Bladder prolapse (cystocele) symptoms & treatment

A bladder prolapse or cystocele is a condition where your bladder drops or sags into your vagina. It’s the most common type of pelvic organ prolapse. When your pelvic floor muscles and ligaments weaken and stretch, they can no longer hold your pelvic organs in place and a type of prolapse occurs.

Bladder prolapse is treatable and your case can be mild or severe. If you have symptoms, our experts provide a range of nonsurgical and surgical treatment options for you.

Bladder prolapse symptoms

You might not notice any symptoms, especially if you have a mild bladder prolapse. In severe cases, your daily life might be impacted by uncomfortable symptoms.

Bladder prolapse symptoms include:

• Pain or a feeling of fullness in your pelvis
• Having a slow urine stream
• Difficulty starting the flow of urine
• Frequent or urgent urination
• Feeling like you need to urinate even though you finished urinating
• Seeing a bulge out of your vagina
• Feeling like something is falling out of your vagina

These symptoms may worsen if you stand for long periods of time, have a cough or lift heavy items. You can improve your symptoms by resting and laying down.

Bladder prolapse stages

The stage of a prolapsed bladder is based on how far the bladder has dropped.

• Stage I: Mild bladder prolapse, where the bladder is still somewhat supported by the pelvic floor muscles and may have dropped into the upper part of the vagina.
• Stage II: The bladder has started to drop into the lower part of the vagina, close to the opening.
• Stage III: The bladder has fallen to or beyond the opening of the vagina and is protruding.
• Stage IV: The bladder has completely fallen through the vaginal opening.

What causes bladder prolapse?

When your pelvic floor muscles weaken, they cannot support organs like your bladder. Support may be impacted by several factors, including:

• Aging: Your pelvic floor muscles and tissues weaken over time.
• Pregnancy and childbirth: The strain and stretching from a vaginal childbirth weakens your pelvic floor muscles.
• Hysterectomy: A hysterectomy can put you at risk of developing the condition.
• Obesity, chronic constipation, chronic coughing and heavy lifting: Adds pressure and strain on the pelvic floor muscles, causing them to weaken.
• Genetics: A family history of pelvic organ prolapse can put you at risk of developing the condition.

Diagnosing bladder prolapse

You’ll first meet with a urogynecologist to review your health history and any symptoms. A pelvic exam can diagnose bladder prolapse. Sometimes, a CT scan or MRI may be needed to get a closer look at the prolapse. Urine and bladder tests may also be recommended to rule out other complications, like a urinary tract infection (UTI) or urinary incontinence.

Bladder prolapse treatments

If you have a mild prolapse that isn’t causing significant symptoms, it may correct itself with nonsurgical treatments. Surgery may be recommended for more severe stages of bladder prolapse.

Nonsurgical options for bladder prolapse treatment

• Biofeedback therapy: Sensors are used to study and improve muscle control.
• Bladder prolapse physical therapy: Physical and occupational pelvic floor physical therapy can strengthen the pelvic floor muscles. Methods include pelvic floor exercises and hands on therapy.
• Vaginal pessary: A soft, removable ring called a pessary can be inserted into the vagina to support the sagging bladder and provide stability and relief.

Surgical treatment for bladder prolapse

A minimally invasive surgery is commonly used to repair bladder prolapse. The procedure uses a surgical mesh to hold the bladder up in place. It's usually done through a very small incision in your abdomen and results in less scarring and a faster recovery time than other surgeries.