Third-degree cystocele: what to know

A cystocele develops when the support between the bladder and front wall of the vagina becomes weaker. A marked prolapse may feel like pressure, dragging, or a vaginal bulge, especially after standing or straining. It can also make starting urine, emptying the bladder, or controlling urine more difficult. The degree describes the position of the prolapse, not how much discomfort a person must have; some people have major symptoms and others have fewer.

A pelvic examination helps confirm the prolapse and identify bladder-emptying or leakage problems. Treatment is chosen around symptoms, general health, sexual activity, future pregnancy plans, and personal preference. A vaginal pessary can support the vaginal wall and may be useful when surgery is unsuitable or when you want a non-surgical approach. Pelvic floor rehabilitation may also help function. Pelvic floor repair surgery is another option for some people after discussion of recovery and possible risks.

Book an appointment if a bulge is new, increasing, or interfering with walking, sex, work, or bowel or bladder function. Seek prompt care if you cannot pass urine, have painful lower abdominal pressure, fever, blood in the urine, or a bulge that becomes very painful, swollen, or difficult to push back. New urinary symptoms should be assessed rather than assumed to be part of prolapse.

Ask how the prolapse is affecting bladder emptying, whether a pessary is suitable, what pelvic floor care could add, and what recovery from repair surgery involves. Ask which symptoms require urgent contact and how follow-up will be arranged.