ABSTRACT
Cystocele results from separation of the vaginal endopelvic fascia from its natural attachment to the arcus tendineous or the White’s line of the pelvis (Figures 19.1 and 19.2). Although rare, a midline defect in this fascial unit results in a midline cystocele. Cystocele can be accompanied by anterior enterocele. Lateral separation of the fascia is more common. It causes unilateral or bilateral paravaginal defects. These are best treated using site-specific repair with restoration of the fascial attachments. Complete repair of all defects gives long-term clinical success.
