International Urogynecology Journal

, Volume 25, Issue 3, pp 387–392

Nine-year objective and subjective follow-up of the ultra-lateral anterior repair for cystocele

  • Zhuoran Chen
  • Vivien Wong
  • Alex Wang
  • Kate H. Moore
Original Article

DOI: 10.1007/s00192-013-2234-4

Cite this article as:
Chen, Z., Wong, V., Wang, A. et al. Int Urogynecol J (2014) 25: 387. doi:10.1007/s00192-013-2234-4


Introduction and hypothesis

The aim of this study was to determine the long-term objective and subjective outcomes of the native tissue ultra-lateral anterior repair for cystocele.


An observational study of patients from a single tertiary centre was carried out from January 1994 to December 2006. Patients who underwent an ultra-lateral anterior repair during this period were sent the Pelvic Floor Distress Inventory (PFDI) questionnaire and invited to return for a POP-Q examination. Symptoms of prolapse, stage of cystocele recurrence and reoperation rate were assessed at follow-up.


Of the 135 patients recruited, 53 also had a POP-Q examination. Mean follow-up was 9.25 years (SD 3.2). The anatomical recurrence rate was 45 % at 9.25 years, but only 26 % of patients had recurrent prolapse symptoms. Most recurrences (43 %) occurred at between 1 and 5 years. The reoperation rate for cystocele was 7.4 %.


Despite these rates of anatomical and symptomatic recurrence, only 7.4 % of patients underwent repeat cystocele surgery. Thus, symptomatic/anatomical recurrence of prolapse often does not mandate surgical correction. Considering that mesh complications require surgical management in approximately 10–15 %, this study supports the notion that the use of mesh in anterior vaginal repairs to reduce the risk of “recurrence” needs careful discussion with each patient.


CystocelePelvic organ prolapseNative tissue repair



Pelvic Floor Distress Inventory


Pelvic organ prolapse quantification


Tension-free vaginal tape


Sacrospinous fixation

Copyright information

© The International Urogynecological Association 2013

Authors and Affiliations

  • Zhuoran Chen
    • 1
  • Vivien Wong
    • 1
  • Alex Wang
    • 2
  • Kate H. Moore
    • 1
  1. 1.Department of Urogynecology, St George HospitalUniversity of New South WalesSydneyAustralia
  2. 2.Statistician, National Perinatal Statistics Unit, School of Women’s and Children’s HealthUniversity of New South WalesSydneyAustralia