- Cystocele is the most common form of pelvic organ prolapse.
- Staging determines whether physiotherapy, a pessary or surgery is recommended.
- Modern repair uses your own tissue in most primary cases.
What is a cystocele?
The bladder sits directly on top of the front wall of the vagina, held there by a layer of connective tissue and the pelvic floor. When that support weakens — after childbirth, with age, after menopause, or with chronic straining — the bladder bulges downward into the vagina. This is called anterior vaginal wall prolapse, cystocele, or in everyday language a dropped bladder.
What it feels like
Most women describe a heavy dragging sensation that gets worse as the day goes on, a visible or palpable bulge at the vaginal opening, difficulty emptying the bladder completely, needing to push the bulge back to finish urinating, recurrent urinary tract infections, and discomfort during sex.
How prolapse is staged
Prolapse is graded from stage 1 (barely dropped) to stage 4 (protruding beyond the vaginal opening). Stage matters because it changes the recommended treatment.
- Stage 1–2: usually managed with pelvic floor rehabilitation and lifestyle changes.
- Stage 3: pessary trial or surgical repair, depending on your priorities.
- Stage 4: surgical repair is usually recommended.
Treatment options
Conservative treatment starts with supervised pelvic floor physiotherapy, weight optimisation, treatment of chronic cough or constipation, and (for postmenopausal women) local vaginal oestrogen. A silicone pessary can hold the bladder in place and is a good option if surgery is not desired.
Surgical repair — anterior colporrhaphy, sometimes combined with paravaginal repair — restores the natural support layer using your own tissue. Most patients stay one night in hospital and are back to light activity within two weeks.
If you are considering treatment from the UK
NHS waiting times for pelvic floor surgery have lengthened considerably; the Royal College of Obstetricians & Gynaecologists reports that many trusts now quote more than 12 months for elective prolapse repair. British women travelling to Istanbul for doctor-led care typically complete their consultation, imaging and surgical planning in a single visit.
Frequently asked questions
Is a bladder prolapse dangerous?
It is not immediately dangerous, but untreated advanced prolapse can cause incomplete bladder emptying, recurrent infections and kidney back-pressure over time.
Can it come back after surgery?
Recurrence rates for a well-planned native-tissue repair are around 10–15% over ten years — lower when combined with pelvic floor rehabilitation.
Do I need mesh?
For most primary cystocele repairs, native-tissue reconstruction is the modern first choice. Mesh is reserved for specific recurrent cases.
Could a doctor-led plan help you?
A 30-minute video consultation with Dr Berra Önsoy — reviewing your symptoms, any UK imaging or referral notes, and giving you a clear, personalised next step. Suitable for women considering treatment from anywhere in the UK.
Request a video consultation