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What Is a Cystocele?

A cystocele, also known as anterior prolapse, is a condition that occurs when a woman’s bladder bulges into her vagina due to weakening of the tissue between the bladder and the vaginal wall. Cystoceles are divided into three grades.

  • Grade 1 — MILD, meaning the bladder has dropped only slightly into the vagina
  • Grade 2 — MODERATE, meaning the bladder has reached the vagina’s opening
  • Grade 3 — SEVERE, meaning the bladder has bulged out through the vagina’s opening

Potential causes of a cystocele include heavy lifting, chronic cough, straining connected to bowel movements, obesity or being overweight, and pregnancy. Certain factors increase your risk of a cystocele, including:

  • Aging
  • Genetics, as some women naturally have weaker connective tissue
  • Hysterectomy
  • Vaginal childbirth


Symptoms vary by the severity of the cystocele:

  • Changes in urination — The frequency or urge to urinate might increase, but it might be harder to begin urinating. Incontinence may also develop.
  • Pelvic, groin and lower back pain — Pain can get worse throughout the day and may be relieved by lying down. Coughing or lifting heavy objects can also cause additional pain.
  • Pelvic heaviness — The position of the bladder within the vagina can cause the pelvic organs to feel full.
  • Vaginal bulge — Because of the bulge, some women experience discomfort while sitting and may feel like they’re sitting on something.

Mild cystoceles don’t always cause symptoms.

Treatment Options

Treatment depends on the severity of your cystocele. If your cystocele doesn’t cause problems, such as blocked urine flow, you may not need treatment.

  • Hormone replacement therapy — Estrogen therapy, available in cream, pill or ring form, can help strengthen pelvic floor muscles in some women. Talk to your doctor about your best options.
  • Lifestyle changes — Doctors may advise avoiding heavy lifting and straining during bowel movements, as these can make cystoceles worse, and doing pelvic floor muscle exercises (Kegels) daily.
  • Supportive device — A pessary (a ring made of rubber or plastic) is placed temporarily in the vagina to hold the bladder in place.

Your doctor may recommend surgery if your symptoms are severe or if you also have a prolapsed uterus.

Ready for an Appointment?

If you're experiencing signs or symptoms of a cystocele, schedule an appointment or call 800-TEMPLE-MED (800-836-7536) today.

Learn more about our doctors and care team who diagnose and treat cystoceles.