A cystocele, also known as a prolapsed bladder, is a form of pelvic organ prolapse where the bladder descends inferiorly and posteriorly into the vagina and perineum. It may be accompanied by prolapse of other pelvic organs.
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Radiographic features
CT / MRI
Sagittal images are particularly useful where the inferior margin of the bladder is often at a lower position than the pubococcygeal line 1. Imaging during strain is suggested to improve detection 3. Additional features that may be detected during dynamic pelvic floor MRI are changes in the urethral angle and involuntary loss of urine into the urethra during defecation.
Fluoroscopic cystocolpoproctography
Instillation of bladder contrast prior to a fluoroscopic pelvic floor study allows evaluation of bladder descent during evacuation.
Treatment and prognosis
A cystocele alone can be treated with a retropubic (Burch) colposuspension, which comprises the suspension of the lateral aspects of the bladder from the pelvic sidewalls. Once the fascia is detached from the tendinous arch, a paravaginal fascial repair is added 3.
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