First-degree cystocele: what to know

A cystocele, also called anterior wall prolapse, occurs when the support between the bladder and front wall of the vagina weakens. The bladder then presses toward the vagina. First degree usually describes a mild descent that remains well inside the vaginal opening. Some people have no symptoms; others notice pelvic pressure, a vaginal bulge, urinary leakage, difficulty emptying the bladder, or symptoms that worsen after standing or straining.

Assessment usually includes a discussion of symptoms and an examination. Constipation, repeated heavy lifting, chronic cough, childbirth, and changes in pelvic support can affect symptoms, but the cause differs between individuals.

Pelvic-floor physiotherapy can teach targeted contractions and relaxation, rather than repeated squeezing without guidance. Prevent constipation with suitable fluids, fibre, and movement, and address a persistent cough with a clinician. Avoid straining and ask how to modify lifting. A vaginal pessary may support the vaginal wall and can be fitted and reviewed by a trained clinician. Surgery is generally considered when symptoms remain troublesome despite conservative care.

Arrange assessment for a new vaginal bulge, worsening pressure, repeated urinary infections, difficulty passing urine, or leakage that affects daily life. Seek urgent care if you cannot empty your bladder, have severe pelvic pain, heavy bleeding, fever, or feel acutely unwell. A clinician can distinguish prolapse from other causes of a vaginal lump.

Ask what degree of prolapse you have, whether your bladder is emptying fully, and which pelvic-floor exercises suit your examination findings. Discuss pessary fitting, review appointments, and when pelvic-floor repair surgery would be considered if symptoms continue.