Anterior vaginal prolapse, also known as a cystocele (SIS-toe-seel) or a prolapsed bladder, is when the bladder drops from its normal position in the pelvis and pushes on the wall of the vagina.
he organs of the pelvis — including the bladder, uterus and intestines — are normally held in place by the muscles and connective tissues of the pelvic floor. Anterior prolapse occurs when the pelvic floor becomes weak or if too much pressure is put on the pelvic floor. This can happen over time, during vaginal childbirth or with chronic constipation, violent coughing or heavy lifting.
Anterior prolapse is treatable. For a mild or moderate prolapse, nonsurgical treatment is often effective. In more severe cases, surgery may be necessary to keep the vagina and other pelvic organs in their proper positions.
In mild cases of anterior prolapse, you may not notice any signs or symptoms. When signs and symptoms occur, they may include:

Signs and symptoms often are especially noticeable after standing for long periods of time and may go away when you lie down.
When to see a doctor
A prolapsed bladder can be uncomfortable, but it is rarely painful. It can make emptying your bladder difficult, which may lead to bladder infections. Make an appointment with your doctor if you have any signs or symptoms that bother you or impact your daily activities.
Your pelvic floor consists of muscles, ligaments and connective tissues that support your bladder and other pelvic organs. The connections between your pelvic organs and ligaments can weaken over time, or as a result of trauma from childbirth or chronic straining. When this happens, your bladder can slip down lower than normal and bulge into your vagina (anterior prolapse).
Causes of stress to the pelvic floor include:

Risk factors
These factors may increase your risk of anterior prolapse:

Diagnosis of anterior prolapse may involve:

Pessary typesOpen pop-up dialog box
Treatment depends on whether you have symptoms, how severe your anterior prolapse is and whether you have any related conditions, such as urinary incontinence or more than one type of pelvic organ prolapse.
Mild cases — those with few or no obvious symptoms — typically don't require treatment. Your doctor may recommend a wait-and-see approach, with occasional visits to monitor your prolapse.
If you do have symptoms of anterior prolapse, first line treatment options include:

When surgery is necessary
If you still have noticeable, uncomfortable symptoms despite the treatment options above, your doctor may recommend surgical treatment.

If you're pregnant or thinking about becoming pregnant, your doctor may recommend that you delay surgery until after you're done having children. Pelvic floor exercises or a pessary may help relieve your symptoms in the meantime. The benefits of surgery can last for many years, but there's some risk of recurrence — which may mean another surgery at some point.
Lifestyle and home remedies
Kegel exercises are exercises you can do at home to strengthen your pelvic floor muscles. A strengthened pelvic floor provides better support for your pelvic organs and relief from symptoms associated with anterior prolapse.
To perform Kegel exercises, follow these steps:

Ask your doctor for instructions on how to properly perform a Kegel, and for feedback on whether you're using the right muscles. Once you've learned the proper method, you can do Kegel exercises discreetly just about anytime, whether you're sitting at your desk or relaxing on the couch.
To help keep an anterior prolapse from progressing, you can also try these lifestyle modifications:

Preparing for your appointment
Make an appointment with your family doctor or gynecologist if you have signs or symptoms of anterior prolapse that bother you or interfere with your normal activities.
Here's some information to help you prepare for your appointment and know what to expect from your doctor.

What you can do

For anterior prolapse, some basic questions to ask your doctor include:

Besides the questions you prepare in advance, don't hesitate to ask other questions during your appointment if you need clarification.
What to expect from your doctor
During your appointment, your doctor may ask a number of questions, such as:

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