Genitourinary Radiology > Bladder > Outpouching of Bladder Wall > Cystocele



Defined as focal herniations of the urothelium and submucosa, cystoceles usually occur in the setting of chronic elevation of intravesical pressure. They tend to occur next to ureteral orifices, and occur when small outpouchings of mucosa evaginate between hypertrophied detrusor muscle bundles, but do not extend past the bladder wall. Cystoceles constitute an important cause of urinary stasis, ureteral obstruction, and vesicoureteral reflux.

Radiographic findings include smooth inner walls and saccules less than 2cm diameter. Stones or, more rarely, carcinoma, may be seen as a filling defects within the diverticula.

Voiding CystoUretethrogram (VCUG) shows with straining, the patient voids while revealing the bladder floor relaxes allowing the bladder base (*) to extend 2 cm below the pubic symphysis (dotted line). This is a cystocele anatomically resulting in stress urinary incontenince.

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