Anterior colporrhaphy is a commonly performed repair of a cystocele. In an anterior colporrhaphy, an incision is made in the front wall of the vagina. The vaginal skin is separated from the bladder wall behind it. The weak or frayed edges of the deep vaginal wall are found and the strong tissue next to edges is sutured to each other lifting the bladder and recreating the strong "wall" underneath it. The vaginal incision is then closed with dissolving stitches. Unfortunately, this part of the pelvic floor is subjected to significant pressure with each cough or when picking up heavy things. As many as one third of women will develop recurrent anterior prolapse after an anterior colporrhaphy. To reduce this recurrence of prolapse, a surgeon may chose to place a "patch" of graft material over the repair line to reinforce the repair. Studies are in progress to help us learn whether or not using grafts provides superior results when compared to traditional surgeries. The studies will also compare the risks of the two types of procedures and who benefits most from the mesh reinforcements.

ACOG, "Pelvic support problems" AP012