Mild cystocele

The tissues supporting the bladder and front vaginal wall have become less firm, allowing the bladder to bulge toward the vagina. Some people notice heaviness, a vaginal bulge or difficulty emptying the bladder; others learn about a cystocele during an examination and feel nothing.

Symptoms may become more noticeable after standing, lifting, coughing or straining. Constipation, repeated heavy lifting and changes after childbirth can increase pressure on the pelvic floor, but the finding is not a measure of personal failure or poor hygiene.

A clinician can assess the prolapse and check how well your bladder empties. Pelvic-floor rehabilitation may help you learn targeted contractions and ways to reduce straining. Treat constipation, use good lifting technique and discuss persistent coughing or other pressure on the pelvic floor.

If symptoms interfere with exercise, work or intimacy, a vaginal pessary may support the vaginal wall. A clinician fits and reviews it because the size and cleaning plan need to suit your body. Surgery is another option when symptoms remain troublesome despite conservative care; pelvic floor repair surgery can be discussed with a specialist.

Arrange prompt medical advice if you cannot pass urine, develop repeated urinary infections, see blood in your urine, or have a rapidly worsening bulge or pelvic pain. Seek urgent help for severe pain with inability to urinate.

A new or changing vaginal bulge should be examined so the clinician can identify the type and degree of prolapse and rule out another cause.

Ask how mild the prolapse is, whether you are emptying your bladder fully, which pelvic-floor exercises are appropriate, and whether a pessary could help. Ask what activities to modify and when a follow-up examination is useful.