# Cystocele (bladder prolapse)

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD66.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Pelvic Organ Prolapse - StatPearls (NCBI Bookshelf NBK563229) - https://www.ncbi.nlm.nih.gov/books/NBK563229/
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
CYSTOCELE (BLADDER PROLAPSE)
Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD66.00 -
         condition scope only, no dose · No dose - referral pathway, no medicine given in primary
         care · Pelvic Organ Prolapse - StatPearls (NCBI Bookshelf NBK563229) -
         https://www.ncbi.nlm.nih.gov/books/NBK563229/
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (3)
    - A sense of vaginal bulge that may worsen with time or affect daily and sexual activity
    - Associated stress or urgency incontinence, difficulty voiding, or needing manual splinting to
      void
    - A feeling of pelvic pressure or sexual discomfort accompanying the bulge
  SIGNS - what you find (5)
    - Anterior compartment descent is best elicited on split-speculum exam during Valsalva or
      coughing  [cough]
    - A single-blade Sims speculum aids visualization of the anterior wall to identify a cystocele
      [genital prolapse]
    - Prolapse not fully seen supine may only be apparent with the patient standing
    - Pelvic floor muscle tone is graded as absent, weak, normal, or strong
    - Vaginal mucosa may show atrophy, irritation, or ulceration on inspection  [atrophy]
  TESTS (3)
    - POP-Q or Baden-Walker scoring stages descent relative to the hymen on a 0 to 4 scale
    - Dynamic MRI or defecography may help in complex or multicompartment cases, though exam remains
      central
    - Post-void residual, urodynamics, or stress-cough testing evaluate coexisting urinary
      dysfunction
  IF NOT THIS - what else fits (3)
    - Urethral diverticulum, a Gartner duct cyst, or a Bartholin gland cyst or abscess can mimic a
      bulge as a vaginal mass
    - A vaginal neoplasm can present as a mass mimicking the prolapse bulge
    - Rectocele, enterocele, and prolapsed ureterocele are other anatomic variants that can resemble
      or coexist with a cystocele
  Source  StatPearls "Pelvic Organ Prolapse" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Cystocele, the anterior-compartment form of pelvic organ prolapse; same GP role as
            prolapse generally - recognise, advise conservative measures, and refer for pessary or
            surgical repair. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Cystocele, the anterior-compartment form of pelvic organ prolapse; same GP role as
            prolapse generally - recognise, advise conservative measures, and refer for pessary or
            surgical repair.
   Caution  No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - Urinary retention, recurrent urinary tract infections, or a visible or
            palpable bulge causing ulceration: refer.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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