- Bladder prolapse, or cystocele, is a form of pelvic organ prolapse: the bladder slips toward the vagina because the supporting tissues have weakened. It often shows up as pelvic heaviness, a vaginal bulge and urinary issues.
- It is classified into 4 stages and diagnosed by a clinical examination carried out by a midwife, a gynaecologist or a urologist.
- Pelvic floor rehabilitation is the recommended first-line treatment. A pessary and surgery are other options, chosen according to the discomfort and the stage.
A feeling of heaviness in the lower abdomen, or the sense of a “bulge” inside the vagina, are often the first warning signs of a pelvic organ prolapse that may involve the bladder. In medical terms, this is called a cystocele. Prolapse affects 3 to 6% of women based on reported symptoms, and up to 50% when assessed clinically (Barber and Maher, 2013). It is not inevitable: concrete options exist to regain daily comfort.
What is a bladder prolapse?
A bladder prolapse (cystocele) is the downward displacement of the bladder toward the vagina. The wall separating the bladder from the vagina stretches and bulges into the vaginal canal because of a weakening of the supporting tissues (fascia and ligaments) and the pelvic floor muscles. It is also referred to as an anterior vaginal wall prolapse.
What are the stages of a bladder prolapse?
Healthcare professionals classify a cystocele into 4 stages, based on the position of the bladder relative to the vaginal opening when the patient bears down:
- Stage 1: the bladder descends slightly into the vagina, without reaching the opening. It often goes unnoticed.
- Stage 2: the vaginal wall reaches the level of the vaginal opening.
- Stage 3: the vaginal wall extends past the opening.
- Stage 4: the vaginal wall is fully exteriorised.
The more advanced the stage, the more pronounced the symptoms tend to be. However, the perceived discomfort does not depend only on the stage — it is what guides the choice of treatment.
What are the symptoms of a bladder prolapse?
The symptoms of pelvic organ prolapse are often related to the stage. In early stages, bladder prolapse may cause no symptoms at all. The most common signs are:
- A sense of pelvic heaviness: a dull pressure in the pelvis, often described as “something pulling or pushing down”, which worsens at the end of the day.
- A vaginal bulge: a feeling of fullness, or a visible or palpable bulge at the vaginal opening.
- Urinary issues: difficulty emptying the bladder completely, weak urine stream, urgent or frequent urination (pollakiuria), urinary leakage.
- Dyspareunia: pain or discomfort during sexual intercourse.
How do I know if I have a bladder prolapse?
If you experience these symptoms, see a midwife, a gynaecologist or a urologist. The diagnosis relies on a clinical examination: the practitioner asks you to bear down to evaluate how far the bladder descends and to determine the stage. Depending on your symptoms, additional tests such as urodynamic studies may be offered.
What causes a bladder prolapse?
A bladder prolapse results from a weakening of the structures that hold the organs of the small pelvis in place. Several factors often combine:
- Vaginal deliveries, which stretch the muscles and the supporting tissues.
- Menopause and ageing, with the drop in oestrogen levels making tissues less resilient.
- Repeated pushing efforts: chronic constipation, chronic cough, frequent lifting of heavy loads.
- Being overweight, which increases pressure on the pelvic floor.
- Certain pelvic surgeries, such as hysterectomy (removal of the uterus).
What are the consequences of a bladder prolapse?
Beyond physical discomfort, a cystocele can affect every area of life:
- Daily discomfort: standing for long periods or walking can become tiring at the end of the day, as gravity increases the pressure.
- Reduced physical activity: discomfort or the fear of worsening symptoms often holds women back from exercise.
- Recurrent urinary tract infections: when the bladder empties poorly, residual urine (post-voiding residual) favours bacterial growth.
- Psychological, intimate and social impact: body-image anxiety and urinary issues can lead to social withdrawal and weigh on intimate life.
How is a bladder prolapse treated?
Several validated therapeutic options exist to treat a bladder prolapse, ranging from rehabilitation to surgery, with mechanical devices in between. Depending on the severity of the prolapse, conservative (non-surgical) methods are always the first choice.
Pelvic floor rehabilitation
It is the first-line treatment to manage a bladder prolapse. Delivered by a physiotherapist or a midwife, it aims to strengthen the pelvic floor so it can better support the organs. Kegel exercises and biofeedback are particularly effective in learning to lock the pelvic floor during effort. Consistency is key. On prescription, these sessions can be partly or fully covered by national or private health insurance in many countries — check with your healthcare provider.
Emy Trainer: technology at the service of your pelvic floor
This is where the Emy solution comes in. This connected probe, a CE-marked medical device, uses biofeedback technology: it captures your pelvic floor contractions and transmits them in real time to your smartphone through fun, interactive games.
- Proven effectiveness: you visualise your efforts, which helps you perform Kegel exercises correctly, without the risk of pushing downward.
- Autonomy and comfort: you train at home, at your own pace, as a complement to your sessions with a healthcare professional.
It is also worth noting that 2 out of 3 women who use Emy Trainer long-term for their pelvic floor rehabilitation report a significant improvement in their prolapse-related symptoms (based on a survey conducted among our users).
What our users say
The impact of active rehabilitation is best measured through the experience of those who have taken the step:
“I noticed the effects of the Emy Trainer probe when I felt the weight of my bladder less. I also feel the contractions of my pelvic floor better, I am more aware of these muscles.” – Maryse (testimonial originally collected in French) (read the full testimonial)
“I’m very happy with this probe, Emy is really effective. After 2 weeks of use, I already feel improvements in my pelvic floor.” – Monique (testimonial originally collected in French) (read the full testimonial)
Read all testimonials from users living with prolapse
Wearing a pessary
A pessary is a silicone device inserted into the vagina to support the bladder. It is an invasive solution but very effective in immediately relieving symptoms, particularly during physical activity or for patients who prefer to avoid surgery.
Surgery
Prolapse surgery is considered when conservative treatments fail and the prolapse becomes bothersome. The procedure aims to reposition the bladder and reinforce the supporting tissues, carried out vaginally or laparoscopically depending on the case. Recovery time and the timeline for returning to activity are set by your surgeon.
How to relieve a bladder prolapse naturally?
To slow progression and ease discomfort, a few daily habits are essential:
- Try hypopressive exercises: unlike classic abdominal workouts, they reduce intra-abdominal pressure and “lift” the organs upward.
- Avoid constipation: straining during bowel movements worsens the prolapse. Placing a small footstool under your feet on the toilet is recommended.
- Manage heavy lifting: avoid carrying heavy objects. Learn to engage your pelvic floor before any effort (cough, sneeze, lifting) and always breathe out during the effort, while contracting your pelvic floor.
FAQ — Bladder prolapse
Can a bladder prolapse go away on its own?
A bladder prolapse does not usually resolve on its own. In the early stages, however, it can remain stable for a long time, and the discomfort can be eased by pelvic floor rehabilitation, a pessary and healthy daily habits. Regular medical follow-up helps adapt the care plan.
Stage 1 bladder prolapse: what should I do?
At stage 1, a cystocele often causes little or no symptoms. The approach relies primarily on pelvic floor rehabilitation with a healthcare professional and on limiting pushing efforts (constipation, heavy lifting).
Can a bladder prolapse happen after a hysterectomy?
Yes, removing the uterus is one of the factors that can favour pelvic organ prolapse, including cystocele. If you experience heaviness or urinary issues after the procedure, talk to your gynaecologist.
Can a bladder prolapse cause urinary tract infections?
Yes. When the bladder empties poorly, residual urine favours bacterial growth and can lead to recurrent urinary tract infections. See a healthcare professional if infections keep coming back.
Can I have sex with a bladder prolapse?
Yes. Prolapse may change comfort or desire, but intercourse remains possible. Read our gynaecologist’s advice on having sex with a pelvic organ prolapse.
Key takeaways
Bladder prolapse is a common condition that requires an appropriate care plan. By acting as soon as the first symptoms appear, it is entirely possible to stop the progression of the prolapse and regain daily comfort.
- Listen to your body: unusual pelvic heaviness or urinary leakage are warning signs that warrant a consultation.
- Prioritise conservative treatments: pelvic floor rehabilitation and the pessary are effective ways to stabilise a cystocele before considering surgery.
- Strengthen your pelvic floor with Emy: regular pelvic floor training is crucial. The Emy Trainer probe, a medical device using biofeedback, allows you to perform clinically validated exercises at home to sustainably tone your pelvic floor and effectively manage your urinary symptoms.
Sources
- Le prolapsus génital (ou « descente d’organes ») : Fiche d’information, Haute Autorité de Santé (HAS), Avril 2022, Fiche Patient (HAS) – link
- Comprendre le prolapsus génital ou « descente d’organes », l’Assurance Maladie (Ameli.fr), Février 2026, Ameli.fr – link
- Prolapsus de la paroi vaginale antérieure et postérieure, Charles Kilpatrick, Septembre 2024, Le Manuel MSD – link
- Epidemiology and outcome assessment of pelvic organ prolapse, Matthew D Barber, Christopher Maher, November 2013, International Urogynecology Journal 24(11):1783-90 – link
- Vaginal pessary for prolapse: anchor, wedge, and ball/socket—a proposed classification system based on its mechanism of action, S. Abbas Shobeiri, Manon H. Kerkhof, Liesbeth P. J. van der Loo, S. J. C. M. (Stanny) Luykx, Hans Peter Dietz, February 2016, International Urogynecology Journal 27(2):299-304 – link
- Prospective evaluation of the connected biofeedback EMY Kegel trainer in the management of stress urinary incontinence, Jochum F et al., February 2022, Journal of Gynecology Obstetrics and Human Reproduction 51(2):102280 – link
