Introduction: Anterior vaginal wall prolapse (AVWP), previously known as cystocele, is a herniation of the anterior vaginal wall and the bladder. It is a multifactorial pathology. Patients with AVWP may report a feeling of pelvic pressure and something bulging out of the vagina, urinary incontinence, and dyspareunia which are nonspecific symptoms. Case: A 73-year-old married Turkish G4P4 female who had been menopausal for 20 years presented to the outpatient clinic with dysuria and urinary incontinence lasting for two weeks and a palpable mass located in the genital area for two years. On her vaginal examination, the vagina and cervix appeared normal, and a grade 3 AVWP, along with a semi-mobile mass extending from the distal urethra to the bladder base under the cystocele pouch, was observed. She was diagnosed with a grade 3 AVWP with a plan for the surgical excision. A bilobular cystic mass was observed under the urethra, extending to the bladder wall with a size of 4-5 cm. The macroscopic examination showed a membranous tissue piece of 4.5 x 2.8 x 2 cm, and the microscopic examination revealed a caseified granulomatous inflammation. Upon the suspicion of tuberculosis, we referred her to the infectious diseases (ID) clinic. Her PPD test was 0 mm. She had no complaints of active tuberculosis. She presented to our clinic with urinary incontinence. On her vaginal examination, we observed involuntary urine leakage with bladder stimulation. We planned the implantation of transvaginal tape (TVT). Discussion: We believe this case will help establish an idea about the differential diagnosis of AVWP. The differential diagnosis should include the other possible genitourinary pathologies due to the proximity of the anterior vaginal wall to the bladder and the urethra before ensuring the diagnosis of the AVWP in order not to misdiagnose.