[9][10] Causes include childbirth, constipation, chronic cough, heavy lifting, hysterectomy, genetics, and being overweight.

[1][2][6] The underlying mechanism involves weakening of muscles and connective tissue between the bladder and vagina.

The resulting incontinence puts women at risk of being placed in a nursing home or long-term care facility.

[medical citation needed] A cystocele occurs when the muscles, fascia, tendons and connective tissues between a woman's bladder and vagina weaken, or detach.

[19] Some women with connective tissue disorders are predisposed to developing anterior vaginal wall collapse.

The tissues tensile strength of the vaginal wall decreases when the structure of the collagen fibers change and become weaker.

[25] The initial assessment of cystocele can include a pelvic exam to evaluate leakage of urine when the women is asked to bear down or give a strong cough (Valsalva maneuver), and the anterior vaginal wall measured and evaluated for the appearance of a cystocele.

This x-ray shows the shape of the bladder and lets the doctor see any problems that might block the normal flow of urine.

[citation needed] The pelvic organ prolapse quantification (POP-Q) assessment, developed in 1996, quantifies the descent of the cystocele into the vagina.

[6][13] The POP-Q provides reliable description of the support of the anterior, posterior and apical vaginal wall.

Cystocele that develops laterally is associated with an anatomic imbalance between anterior vaginal wall and the arcus tendineus fasciae pelvis – the essential ligament structure.

[32] Since the failure rate in cystocele repair remains high, additional surgery may be needed.

[33] The surgical treatment of cystocele will depend on the cause of the defect and whether it occurs at the top (apex), middle, or lower part of the anterior vaginal wall.

[32] This surgical procedure consists of making a longitudinal folding of the vaginal tissue, suturing it into place and creating a stronger point of resistance to the intruding bladder wall.

[32] During surgery, the repair of the vaginal wall consists of folding over and then suturing the existing tissue between the vagina and bladder to strengthen it.

[32] Sacrocolpopexy is a procedure that stabilizes the vaginal vault (the uppermost portion of the vagina) and is often chosen as the treatment for cystocele, especially if previous surgeries were not successful.

[22] If an enterocele/sigmoidocele, or prolapse of the rectum/colon, is also present, the surgical treatment will take this concurrent condition into account while planning and performing the repairs.

[33] Another review on the surgical management of cystocele describes a more successful treatment that more strongly attaches the ligaments and fascia to the vagina to lift and stabilize it.

The complications following surgical treatment of cystocele are: After surgery, a woman is instructed to restrict her activities and monitor herself for signs of infection such as an elevated temperature, discharge with a foul odor and consistent pain.

[13] One goal of surgical treatment is to restore the vagina and other pelvic organs to their anatomically normal positions.

This may not be the outcome that is most important to the woman being treated who may only want relief of symptoms and an improvement in her quality of life.

The International Urogynecological Association (IUGA) has recommended that the data collected regarding the success of cystocele and pelvic organ repairs include the presence or absence of symptoms, satisfaction and Quality of Life.

Other measures of a successful outcome should include perioperative data, such as operative time and hospital stay.

Standardized Healthcare Quality of Life should be part of the measure of a successful resolution of cystocele.

Data regarding short- and long-term complications is included in the recommendations of the IUGA to better assess the risk–benefit ratio of each procedure.

[13] In the US, greater than 200,000 surgeries are performed each year for pelvic organ prolapse and 81% of these are to correct cystocele.

Based on population growth statistics, the number of women with prolapse will increase by a minimum of 46% by the year 2050 in the US.

He thought that recent childbirth, wet feet, 'sexual excesses', exertion, and fatigue may have contributed to the condition.

In 350 A.D., another practitioner named Soranus described his treatments which stated that the pomegranate should be dipped into vinegar before insertion.

Beginning in 1976, improvement in suturing began along with the surgical removal of the vagina being used to treat prolapse of the bladder.