Int Urogynecol J (2011) 22:557–561 DOI 10.1007/s00192-010-1353-4 ORIGINAL ARTICLE Technique of anterior colporrhaphy: a Dutch evaluation Ellen J. M. Lensen & Jackie A. Stoutjesdijk & Mariella I. J. Withagen & Kirsten B. Kluivers & Mark E. Vierhout Received: 7 October 2010 / Accepted: 16 December 2010 / Published online: 25 February 2011 # The Author(s) 2011. This article is published with open access at Springerlink.com Abstract Introduction and hypothesis To evaluate the variation in techniques of anterior colporrhaphy among members of the Dutch Urogynecologic Society. Methods A questionnaire evaluating the technique of anterior colporrhaphy, preoperative and postoperative care, and use of the POP-Q score was sent out by e-mail. Results One hundred thirty-three completed questionnaires were received. The response rate was 65%. There are large variations in incisions, use of hydrodissection, method of plication, and excision of redundant vaginal epithelium. The urinary catheter was generally removed on day 2 after surgery and the vaginal pack on day 1. Less than half of the respondents used the POP-Q score routinely. Conclusions Dutch gynecologists use a variety of surgical techniques to operate on a cystocele. This suggests that there is no widely accepted opinion on the best surgical approach. The lack of differentiation between central and lateral defects is striking and in contrast with the, mostly, American literature. Keywords Anterior colporrhaphy . Cystocele . Pelvic organ prolapse . POP-Q E. J. M. Lensen : J. A. Stoutjesdijk Obstetrics and Gynecology, Canisius-Wilhelmina Hospital, Nijmegen, Netherlands M. I. J. Withagen : K. B. Kluivers : M. E. Vierhout Obstetrics and Gynecology, UMC St. Radboud, Nijmegen, Netherlands E. J. M. Lensen (*) Kersenlaan 45, 5345 JL Oss, The Netherlands e-mail: ellen@lensen.nu Abbreviations AUGS American Urogynecologic Society POP Pelvic organ prolapse POP-Q Pelvic organ prolapse quantification Introduction Pelvic organ prolapse (POP) is known to affect up to 50% of women with a lifetime risk of undergoing surgery for POP or incontinence of 11% [1]. Recurrence rates after surgery are high and especially anterior vaginal wall prolapse is known to recur frequently, with recurrence rates following anterior colporrhaphy anywhere between 0% and 92% [2]. To prevent recurrence of a cystocele after repair, different techniques have been used, for example paravaginal repair (abdominal or vaginal), ultralateral anterior colporrha- phy, and the use of different grafts and meshes. All these different techniques, except the use of grafts, have had disappointing results to date. Studies comparing techniques have shown no differences in the risk of recurrence [3]. In 2008, Shippey described a survey of the American Urogynecologic Society (AUGS) members of the contem- porary approaches to cystocele repair [4]. Their research mainly compared the differences between generalist and fellowship-trained urogynecologists. Since a number of Dutch studies also showed comparable poor anatomical outcome of anterior colporrhaphy, we decided to evaluate the variation in techniques of anterior colporraphy among members of the Dutch Urogynecologic Society in an attempt to get more insight in the variation of techniques and potentially find a reason for the high recurrence [5, 6].