Surgical Treatment for Cystocele and Pelvic Organ Prolapse

Cystocele — anterior vaginal wall prolapse — occurs when the bladder descends into the vaginal canal due to weakened pelvic support structures. When symptoms are bothersome and non-surgical management has been insufficient or declined, surgical repair is the indicated next step.

This protocol addresses surgical management of cystocele (pelvic organ prolapse, POP) in women who are symptomatic and have not responded to, or have declined, non-surgical treatment approaches.

Treatment approach

Surgical repair is indicated and may involve either a vaginal or an abdominal reconstructive approach, depending on the anatomical extent of prolapse and patient factors.

Full procedure selection, technique details, and indication criteria available in the complete protocol →

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References

DOI: 10.1097/AOG.0000000000003519

Surgery is indicated for the treatment of POP in women who are bothered by their POP and have failed or declined nonsurgical treatments.
Vaginal hysterectomy and vaginal apex suspension with vaginal repair of anterior and posterior vaginal wall prolapse as needed are effective treatments for most women with uterovaginal and anterior and posterior vaginal wall prolapse.
Vaginal apex suspension involves attachment of the vaginal apex to the uterosacral ligaments or sacrospinous ligaments.
Abdominal sacrocolpopexy is a proven and effective surgery for the treatment of POP.
This procedure involves placement of a synthetic mesh or biologic graft from the apex of the vagina to the anterior longitudinal ligament of the sacrum.

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