Bladder prolapse can cause several symptoms, including a vaginal bulge, urinary incontinence, frequent voiding of the bladder, and more. There are three stages, or grades, of bladder prolapse.

Females have a collection of supportive tissue and pelvic floor muscles that keep the bladder cradled in a hammock-like structure. If the tissues and muscles become stretched, weakened, or damaged, it can cause the bladder to fall and push into the vagina — a bladder prolapse.

Also known as cystocele, bladder prolapse is a common issue in females. In severe cases, the bladder becomes visible in the vagina opening. A bulging vagina is the most frequent symptom.

This article reviews the main symptoms and signs of bladder prolapse alongside contacting a doctor, diagnosis, treatment, and more.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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A bladder prolapse diagramShare on Pinterest
Medical illustration by Maya Chastain

A prolapsed bladder can cause several potential signs and symptoms. They can differ based on the severity of prolapse.

Doctors generally grade bladder prolapse based on how far the bladder drops into the vagina. The grades also generally correspond to the severity of the condition, with higher grades indicating a more severe condition. The grades include the following:

  • Grade 1: Mild prolapse, often associated with few or no symptoms.
  • Grade 2: Moderate prolapse, associated with additional symptoms and a possible noticeable bulge in the vagina.
  • Grade 3: Severe prolapse, associated with more severe symptoms and a noticeable bulge in the vagina.

Early signs

People may first notice heaviness or pressure in their pelvis or pelvic floor area. Others may have the sensation that something is falling out of their vagina.

Grade 1 symptoms

Grade 1 bladder prolapses may not cause any signs or symptoms in a person. If they do occur, they may be mild.

Symptoms may include:

  • pressure on the pelvic floor or vagina
  • mild discomfort
  • increased urinary urgency

Grade 2 or 3 symptoms

Grade 2 and 3 bladder prolapses are moderate to severe and associated with a bladder that has dropped further into the vagina.

A person may also feel or see a bulge in their vagina. A bulge is more common in grade 2 and 3 prolapses. Some experts describe a bulge as the most common feature of bladder prolapse. A person or doctor may see or feel this bulge on examination.

Though a person may experience these symptoms with a grade 1 prolapse, a person with moderate to severe cases may experience symptoms that include:

How symptoms change

Symptoms of a bladder prolapse are not always consistent.

Different factors can influence a person’s symptoms and severity. They include:

  • Gravity: As the day goes on, a person has a higher chance of feeling worsening symptoms due to the pressure of gravity.
  • Sex: Sexual intercourse can worsen symptoms.
  • Premenopause: A person in premenopause may experience worsening symptoms during their menstrual period.

A person may not need to consult a doctor right away if symptoms are mild or do not cause issues. Someone may only need to contact a doctor if their symptoms worsen.

People should consider consulting a medical professional if their symptoms are moderate to severe and causing issues with their daily lives. A doctor can help diagnose and provide advice on treatment for the prolapse.

Emotional impact

A prolapsed bladder can be upsetting. A person may experience a range of emotions, including depression and mourning the loss of activities they could once do, such as intense exercise or running for long periods.

Some people may feel less sexually desirable or have increased apprehension concerning sexual intercourse.

Recovery can also take some time. People can speak with a doctor for support and guidance on treating and managing their condition.

Diagnosis of bladder prolapse involves determining if a prolapse has occurred and grading the severity.

A doctor will likely review a person’s medical history and perform a physical examination. The exam may involve the person laying or standing and may require the person to push or strain.

In some cases, a doctor may order imaging tests to help determine the severity or confirm the diagnosis. They can include:

Therapy can include conservative treatments and surgery.

Conservative treatments often involve:

If these methods do not work or a doctor suspects they will not be enough to help, they may recommend surgical correction.

Surgery can involve several options, such as open or laparoscopic surgery, and will help fix the structures holding the bladder in place and correct the prolapse.

The following section answers common questions about bladder prolapse.

Can people diagnose it themselves?

A person cannot officially diagnose themselves with a bladder prolapse, though they may be able to determine and feel that the bladder has dropped, particularly if it is severe. It is a good idea to consult a doctor if they suspect a prolapse or notice any signs or symptoms that may indicate a prolapsed bladder.

What are the first signs?

One of the most common signs of a prolapsed bladder is feeling or seeing a bulge in the vagina. However, a person may also notice the following:

  • an increased need to urinate
  • pressure in their pelvis
  • incontinence that may indicate an issue

Are postpartum people more likely to have bladder prolapse?

Pregnancy can increase a person’s risk of bladder prolapse. Some experts indicate that it may be due to the pressure the developing fetus places on the pelvic floor. An older study from 2014 also indicated that vaginal delivery and other potential factors increase a person’s risk of prolapsing from pregnancy.

In either case, a person may experience a vaginal bulge, incontinence, leaking, or other symptoms. People should discuss these with a doctor to receive a diagnosis and treatment.

Is there a link with a hysterectomy and bladder prolapse?

Older research from 2014 associates hysterectomy with an increased risk of pelvic organ prolapse. As the American College of Obstetricians and Gynecologists confirms, bladder prolapse can occur in a person without a uterus.

Further research also associates hysterectomy with risk factors, including urinary incontinence and uterine prolapse. A person may want to discuss their symptoms with a doctor.

What are bowel prolapse symptoms, and how do they differ?

A bowel or rectal prolapse occurs when the rectum drops down into the anus. Unlike vaginal prolapse, which is relatively common, rectal prolapse is less common and affects about 2.5 out of every 100,000 people.

Symptoms differ from a bladder prolapse but have similar features, including:

A person may not experience any symptoms from a prolapsed bladder. They may not know they have it until a vaginal examination.

Those with mild to moderate symptoms may improve with noninvasive options, such as pelvic floor exercises and physical therapy.

People with severe symptoms may require surgery or a longer therapy timeline.

With treatment, a prolapsed bladder can improve. However, it can take some time with therapy and recovering from surgery, if necessary.

A prolapsed bladder can cause various symptoms, though some may not notice any changes. The most common tends to be a vaginal bulge that a person or doctor may be able to see or feel.

Other symptoms can include pressure on the groin, pelvic pain or discomfort, leaking urine, increased urgency or frequency of urination, and pain during sexual intercourse, among others.

When symptoms are present, a person should consider discussing treatment options with a doctor. Treatment can help to correct the prolapse and improve symptoms, but the process can take some time.