What is a cystocele?
In perimenopausal and menopausal women, particularly those who have had vaginal childbirth, the support structures of the bladder and urethra become atrophic and lax. This leads to downward descent of the bladder and bladder neck, as well as protrusion of the bladder through the anterior wall of the vagina. Descent of the bladder neck below the level of the pubic symphysis is known as a cystocele.
Assessment for a cystocele is usually performed clinically. On fluoroscopy, descent of the bladder neck over 2 cm below the pubic symphysis with straining maneuvers such as a Valsalva maneuver is indicative of a cystocele.