A cystocele is a condition that occurs when the bladder prolapses or herniates down through the anterior vaginal wall into the vagina. This condition occurs due to loss of the support mechanisms of the pelvic anatomy. Incidence increases with age. Studies have suggested that about 40%-50% of women develop some form of prolapse as they proceed through menopause.

Risks factors include family history, menopausal status, having vaginal childbirth (especially of larger babies or with assistance of deliveries), multiparity, chronic cough, chronic constipation, straining due to lifting, obesity, prior pelvic surgery including hysterectomy, and other prolapse surgery.

Most often, cystoceles will be found incidentally during routine pelvic exam. Patients may present with a complaint of a bulge from the vagina or increased pelvic, bladder, or vaginal pressure. These symptoms will often resolve when patient is supine. Other patients may note new-onset vaginal spotting with wiping (often postmenopausally) or issues with urinary retention.

Related topic: Uterovaginal prolapse