Grades of cystocele and rectocele

A cystocele is a forward bulge involving the bladder and front wall of the vagina. A rectocele involves the rectum and back wall. Clinicians grade prolapse by examining how far the supported tissue descends, often from inside the vagina towards the opening and beyond. The grade does not always match symptom severity: pressure, difficulty emptying the bladder or bowel, and discomfort can occur at different grades.

A clinician can assess the vaginal walls while you bear down and may check bladder or bowel symptoms. Mild or minimally troublesome prolapse may be managed with pelvic-floor exercises, constipation prevention, and observation. A Vaginal Pessary Fitting can provide internal support. If symptoms remain disruptive, Pelvic Floor Repair Surgery may be considered after discussing recovery, benefits, and possible complications.

Arrange an assessment for a new or enlarging vaginal bulge, pressure, urinary leakage, incomplete emptying, or difficulty passing stool. Seek urgent help if you cannot pass urine, have severe pain, heavy bleeding, or a prolapsed area becomes very swollen or changes colour.

Ask which wall is affected, how the grade was assessed, and whether bladder or bowel tests are needed. Discuss pelvic-floor therapy, pessary care, and when surgery would be reasonable for your symptoms.