This is the medical term for a sagging of the bladder produced by a relaxation of the tissues supporting it. It is limited to women who have been pregnant and is seen as an occasional sequel to pregnancy and delivery.
Only a small minority of mothers, however, develop cystocele of any consequence, and mild degrees of cystocele can be disregarded.
A large cystocele is detected easily enough by inspection. The patient is told to bear down as though she were having a bowel movement. The increased pressure within the abdomen will push the sagging bladder down into the upper wall of the vagina, thus producing a bulge at the vaginal opening. It is this anatomical fact that leads to the difficulties of cystocele, for it may be difficult or impossible to evacuate the bladder completely. This alone may lead to frequency of urination. It is also a general fact that infection is likely to occur whenever the bladder cannot be completely emptied. Thus there may be frequent episodes of cystitis with all the discomfort that these can bring. It is sometimes possible, at least partially, to correct the difficulty produced by a cystocele by inserting a pessary into the vagina to support the bladder.
For cystocele of a degree that produces frequent symptoms or infections, surgery is recommended. The aim is to fashion a sling of supporting tissue that will hold the bladder in a normal location. When this is done, the symptoms due to cystocele disappear.