Anterior Vaginal Prolapse (Cystocele) – Symptoms and Causes

Overview

Anterior vaginal prolapse happens when the bladder slips out of place and presses against the vagina wall. This condition is also called a cystocele or prolapsed bladder.

Normally, pelvic floor muscles and tissues keep organs like the bladder, uterus, and intestines in their proper positions. When these supporting structures weaken or face too much pressure, prolapse can occur.

Several factors can lead to this condition. Vaginal childbirth puts significant stress on the pelvic floor. Other causes include chronic constipation, heavy lifting, or persistent coughing. The problem typically develops gradually over time.

For mild to moderate cases, non-surgical approaches often work well. These might include:

• Pelvic floor exercises
• Supportive devices
• Lifestyle changes

More severe cases may require surgery to reposition and secure the pelvic organs properly. Most people can find effective solutions for this common condition with proper medical guidance.

Signs and Bladder Prolapse

A mild bladder prolapse might not cause any noticeable problems. However, when symptoms do appear, they can include:

• Feeling of fullness or pressure in the pelvic area and vagina
• Visible or feelable tissue bulge in the vagina
• Increased pelvic pressure when straining, coughing, lifting, or bearing down
• Urinary difficulties include:
  • Trouble starting urination
  • Feeling like the bladder isn’t empty after using the bathroom
  • Needing to urinate often
  • Leaking urine

These symptoms often get worse after standing for long periods and may improve when lying down.

When Medical Help Is Needed

While a prolapsed bladder typically causes discomfort rather than pain, it can interfere with proper bladder emptying and potentially lead to infections. It’s important to contact a healthcare provider if you experience any symptoms that:

• Cause you concern
• Interfere with your daily activities
• Affect your quality of life

Early treatment can help manage symptoms and prevent complications.

Causes

The pelvic floor includes muscles, ligaments, and tissues that hold up the bladder and other organs in the pelvis. These supports can get weak over time. When this happens, the bladder may drop down and push into the vagina.

Several factors can put stress on the pelvic floor:

• Pregnancy and childbirth through the vagina
• Excess weight from being overweight or obese
• Heavy lifting done many times
• Straining during bowel movements
• Long-term coughing or bronchitis

These stresses can stretch and weaken the connections between pelvic organs and the ligaments that support them. This weakening happens slowly over time in some cases, or suddenly due to childbirth or other trauma.

Risk Factors

Several factors can increase your chance of developing anterior prolapse. Being aware of these risk factors may help you understand your personal risk level.

Pregnancy and Childbirth

Women who have given birth vaginally face a higher risk. The risk increases with:

• Multiple pregnancies
• Babies with high birth weight
• Deliveries requiring instruments like forceps

Age-Related Changes

As you get older, your risk grows. After menopause, your body produces less estrogen, which normally helps keep pelvic floor muscles strong.

Previous Surgeries
Having your uterus removed (hysterectomy) might weaken your pelvic floor in some cases, though this doesn’t happen to everyone.

Genetic Factors

Some women naturally have weaker connective tissues in their pelvic area. This genetic difference can make them more likely to develop anterior prolapse.

Weight Considerations

Carrying extra weight puts additional pressure on your pelvic organs. Women who are overweight or obese face a higher risk of developing this condition.

Other Contributing Factors

• Chronic coughing
• Constipation with straining
• Heavy lifting on a regular basis
• Certain connective tissue disorders