How are you diagnosed with a cystocele?

Visually. If during a female exam the dr asks you to "bear down-as if having a bowel movement" we are looking for any weakness in the "pelvic floor"which is the area from the bottom of your pubic hair to your tail-bone.A bulge here suggests to us where the weakness is.
Physical exam. A cystocele is usually diagnosed by physical exam. Your doctor will have you bear down while watching your bladder. If the bladder prolapses or drops towards or through the vaginal opening that's a cystocele. It is best to perform exam with you lying down and with you standing up.