Transabdominal repair of cystocele, a 20 year experience, compared with the traditional vaginal approach.

In patients with pelvic floor relaxation and concomitant pelvic pathology indicating the abdominal approach the so-called "combined" operation is not a satisfactory technique. During the course of the total abdominal hysterectomy the cystocele can well be repaired by mobilizing the bladder and excising the relaxed vaginal mucosa. The technique is described and its efficiency in 76 cases is compared to 109 cases repaired by the traditional vaginal approach. Over a 20 year period, 92% of the former as compared to 78% of the latter showed a satisfactory result. Both series revealed that time plus anatomic stress are the major factors in those patients in whom the pelvic floor relaxation recurred.