Anterior vaginal wall prolapse: The challenge of cystocele repair
What’s the best strategy? Repairs often fail and the literature is inconclusive. Three experts analyze what we can learn from the limited studies to date, and offer tips on technique.
The gold standard, for now
Prolapse of the anterior vaginal wall remains a challenge for the gynecologic surgeon. Careful preoperative and intraoperative evaluation and identification of support defects should guide repairs.
Randomized, controlled trials of midline versus paravaginal repair, as well as use of various graft materials, are greatly needed. These studies should not only address recurrence of prolapse symptoms, but the impact of surgery on sexual and lower urinary tract function.
At this time, the traditional anterior colporrhaphy with attention to apical suspension remains the gold standard.
The authors report no financial relationships relevant to this article.
