A hernia of the bladder through the vaginal wall, also known as 'fallen bladder'.

A hernia of the bladder through the vaginal wall, also known as 'fallen bladder'.

• A. Urethrorrhagia
• B. Vesicovaginal Fistula
• C. Cystocele
• D. Cystitis

Answer: (C)

The key idea here is a bulge of the bladder into the vaginal wall due to weakness of the pelvic floor, which is called a cystocele. The bladder sits just in front of the vagina, and when the supporting tissues (like the pubocervical fascia) weaken, the anterior vaginal wall can widen and the bladder can descend into or beyond the vaginal canal. This is why it’s described as a “fallen bladder”—the bladder itself protrudes through the vaginal wall. This condition is distinct from a vesicovaginal fistula, which is an abnormal channel between the bladder and vagina that causes urine to continuously leak into the vagina, not a simple prolapse. Urethrorrhagia is bleeding from the urethra, and cystitis is bladder inflammation; neither describes bladder herniation into the vaginal wall.

The key idea here is a bulge of the bladder into the vaginal wall due to weakness of the pelvic floor, which is called a cystocele. The bladder sits just in front of the vagina, and when the supporting tissues (like the pubocervical fascia) weaken, the anterior vaginal wall can widen and the bladder can descend into or beyond the vaginal canal. This is why it’s described as a “fallen bladder”—the bladder itself protrudes through the vaginal wall.

This condition is distinct from a vesicovaginal fistula, which is an abnormal channel between the bladder and vagina that causes urine to continuously leak into the vagina, not a simple prolapse. Urethrorrhagia is bleeding from the urethra, and cystitis is bladder inflammation; neither describes bladder herniation into the vaginal wall.