ABSTRACT
The durable surgical correction of pelvic organ prolapse remains a significant challenge for
pelvic reconstructive surgeons. Prolapse of the anterior vaginal wall, usually in the form of a
cystocele, is the most common form of pelvic organ prolapse (1). Recent studies suggest
that, of the various segments of the vagina which may be involved in prolapse (anterior,
posterior, or apical), the anterior vaginal wall is the segment most likely to demonstrate recur-
rent prolapse after reconstructive surgery (2). Additionally, normal anterior vaginal support
plays an important role in supporting the urethra and loss of this support can contribute to
the development of stress urinary incontinence (3). It is therefore important that the pelvic
reconstructive surgeon understand the normal support mechanisms of the anterior vaginal
wall and the full spectrum of techniques for correction of anterior vaginal prolapse and
cystoceles.
