Cystocele/Fallen Bladder

Factors contributing to an increased risk for developing a fallen bladder include:

• Heavy lifting
• Straining muscles during childbirth
• Multiple pregnancies
• Menopause
• Repeated straining during bowel movements
• Chronic coughing
• Obesity
• Previous pelvic surgery

Women with a fallen bladder may experience the following symptoms:

• Feeling of pelvic heaviness, fullness or pressure
• Painful bladder
• Pain in the vagina, pelvis, lower abdomen, groin or lower back
• Bulge in the vagina that you can feel
• Tissue protruding from the vagina that is tender or bleeding
• Frequent urination or urge to urinate
• Not feeling bladder relief after urinating
• Frequent urinary tract infections
• Leakage of urine (incontinence) or constipation
• Painful intercourse
• Problems with inserting tampons or applicators
• Pelvic pressure gets worse with standing, lifting, or coughing as the day progresses

Your urologist will conduct a variety of tests to determine if you have a fallen bladder:

• Medical history
• Physical examination including a pelvic exam
• Voiding cystourethrogram, X-rays during urination to determine the shape of the bladder and any obstruction.
• Uroflowmetry measures the amount and speed of the urine.
• Cystometry measures how much your bladder can hold, how much pressure builds up inside your bladder as it stores urine, and how full it is when you feel the urge to urinate.
• Urethral pressure profile measures the different pressures in your urethra as a catheter is slowly removed from the bladder.
• Urodynamics tests help your doctor or nurse see how well your bladder and sphincter muscles work.
• Pressure flow study measures the pressures required to urinate and identifies bladder outlet obstruction.
• Cystoscopy enables a urologist to view the inside of the bladder and urethra via a thin tube.
• Fluoroscopy, a radiological technique for visually examining the bladder.

Depending upon the severity of your cystocele and other factors, including age and health, your urologist will recommend an individualized treatment plan which may include:

• Activity modification to avoid heavy lifting or straining that could worsen your cystocele.
• Behavior therapies such as Kegel exercises to strengthen the pelvic floor.
• Estrogen replacement therapy to strengthen the muscles around the vagina and bladder.
• Pessary, a device placed in the vagina to hold the bladder in place.
• Surgery, a procedure to move the bladder back into a more normal position.

You will receive a thorough diagnostic examination and receive clinically-proven treatment by a board-certified urologist who specializes in female urologic health. Our goal is to alleviate or eliminate symptoms so patients can confidently resume everyday activities. Appointments are confidential and private.

Brigham and Women's Hospital practices a multidisciplinary approach to patient care, collaborating with colleagues in other medical specialties. If your urologist discovers that an underlying illness has contributed to your cystocele, you will be referred to an appropriate BWH physician for an evaluation.

Go to our online health library to learn more about urology diseases and tests.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.