Four-corner bladder and urethral suspension for moderate cystocele

S. Raz, C. G. Klutke, J. Golomb

Research output: Contribution to journalArticlepeer-review


The classical approach to cystocele repair involves the approximation of lax pubocervical fascia through the anterior vaginal wall with narrowing of the bladder neck and proximal urethra by the Kelly-type plication. This procedure corrects the prolapse but when performed for the treatment of incontinence it has a high failure rate because the bladder neck and urethra are not placed into a high, supported, nonobstructed retropubic position. Furthermore, due to elevation of the bladder base without simulataneous elevation of the bladder neck and urethra, de novo stress urinary incontinence may occur. We developed a transvaginal needle suspension operation for the bladder and urethra that repairs anterior vaginal wall prolapse with excellent support of the bladder base and repositions the bladder neck in the high retropubic position, all during a simple and rapid operation that is tolerated well by the patient.

Original languageEnglish
Pages (from-to)712-715
Number of pages4
JournalJournal of Urology
Issue number3
StatePublished - 1989
Externally publishedYes


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