Transvaginal four-corner cystourethropexy using bone anchors

Samuel Levin*, Alexandra E. Benet, Daniel Levin, Doron Korchiak, Rafael Levin, Ami Sidi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background Cystocele repair is achieved by the approximation of the pubocervical fascia through the anterior vaginal wall to its original anatomic position. Surgical repair of this condition can be achieved by a transabdominal approach (open or laparoscopically) or a paravaginal approach. The authors report a genuine transvaginal approach using bone anchors for the repositioning of the bladder neck toward the posterior pubic bone surface. The purpose of the current study was to evaluate the safety and effectiveness of a new less-invasive surgical procedure for the treatment of mild and moderate cystocele combined with type I or type II genuine urinary stress incontinence. Methods After receiving ethical committee approval, 11 consecutive women 42-74 years old (mean, 56 years) with mild to moderate cystocele combined with type I or type II stress urinary incontinence were treated by means of a transvaginal four-corner cystourethropexy using bone anchors. Results Nine patients were completely cured, one improved, and in one no post procedure improvement occurred. No significant complications occurred during or after the procedure. Conclusions Preliminary data suggest that this new less-invasive procedure provides a safe, effective, and easy-to-learn alternative for the treatment of mild to moderate cystocele combined with type I or type II stress urinary incontinence. However, a larger group of patients and longer follow-up time are needed to establish this technique.

Original languageEnglish
Pages (from-to)212-220
Number of pages9
JournalJournal of Pelvic Surgery
Issue number4
StatePublished - 1999


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