Making a DiagnosisA doctor may be able to diagnose a grade 2 or grade 3 cystocele from a description of symptoms, and from physical examination of the vagina, because the fallen part of the bladder will be visible.
A voiding cystourethrogram (sis-toe-yoo-REETH-roe-gram) is a test that involves taking x-rays of the bladder during urination. This x-ray shows the shape of the bladder, and lets the doctor see any problems that might block the normal flow of urine. Other tests may be needed to find a cystocele, or rule out problems in other parts of the urinary system.
Cystocele treatment options range from no treatment, for a mild cystocele, to surgery, for a serious cystocele.
If a cystocele is not bothersome, the doctor may only recommend avoiding heavy lifting, or straining, that could cause the cystocele to worsen.
If cystocele symptoms are moderately bothersome, the doctor may recommend a pessary, which is a device placed in the vagina, to hold the bladder in place. Pessaries come in a variety of shapes and sizes, to allow the doctor to find the most comfortable fit for the patient. Pessaries must be removed regularly to avoid infection or ulcers.
Large cystoceles may require cystocele surgery, to move the bladder back into a more normal position, and keep it there. This cystocele surgery may be performed by a gynecologist, a urologist, or a urogynecologist. The patient should be prepared to stay in the hospital for several days, and take 4 to 6 weeks to recover fully.