Contemporary approaches to cystocele repair: A survey of AUGS members

INTRODUCTION: To assess practice patterns in the management ofcystoceles among American Urogynecologic Society (AUGS) members. STUDY DESIGN: A 22-question survey regarding various cystocele repair techniques was delivered to AUGS members via e-mail. RESULTS: Of 963 members surveyed, there were 315 respondents. For the treatment of primary cystocele, 77% of respondents used midline vaginal plication; 40% used this approach for management of recurrent cystocele. At the time of abdominal sacrocolpopexy, most considered the anterior vaginal graft sufficient to address cystocele. At the time of uterosacral suspension, midline plication was the most common approach to address cystocele. The most commonly used graft material was synthetic mesh (67%). Almost half of respondents used minimally invasive transobturator devices for cystocele repair. CONCLUSION: The wide variety of surgical approaches likely reflects the absence of a clearly defined best practice for cystocele repair, underscoring the need for rigorous surgical trials.