What should you know about a large cyst?

A cystocele, also called bladder prolapse or anterior wall prolapse, occurs when the support between the bladder and front vaginal wall becomes less firm. The bladder then presses downward into the vagina. A larger prolapse may cause a vaginal bulge, pelvic pressure, incomplete emptying, frequent urination or urine leakage. Some people have a visible or felt bulge without major bladder symptoms.

The word large describes the extent of the bulge, not how serious your symptoms must be. An examination helps show the position of the prolapse and whether the bladder is emptying properly.

Arrange an assessment with a gynaecologist or pelvic-floor clinician if a bulge is new, growing, uncomfortable or interfering with urination, exercise or sex. Keep a note of pressure, leakage, difficulty emptying and bowel symptoms. Treatment may include pelvic-floor support, bladder advice, a vaginal pessary fitted to your anatomy, or pelvic floor repair surgery when symptoms remain troublesome. The right choice depends on your examination, health, preferences and future pregnancy plans.

Avoid straining where possible and ask for help with a safe plan for lifting and constipation. Do not push a painful bulge forcefully back into place.

Seek urgent help if you cannot pass urine, have severe pelvic pain, heavy bleeding, fever, vomiting, or a bulge that becomes very painful, swollen or discoloured. Contact a clinician soon for recurrent urinary infections, blood in the urine, new leakage or a bulge that rubs and bleeds.

Ask which support structures are affected, whether your bladder is emptying fully, whether a pessary is suitable, and when surgery should be considered.