title: Contemporary approaches to cystocele repair: a survey of AUGS members.
abstract: BACKGROUND
  To assess practice patterns in the management of cystoceles among American Urogynecologic Society (AUGS) members.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA. sshippe1@jhmi.edu
authors.forename: Stuart
authors.initials: S
authors.lastname: Shippey
authors.forename: Robert E
authors.initials: RE
authors.lastname: Gutman
authors.forename: Lieschen H
authors.initials: LH
authors.lastname: Quiroz
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Handa
mesh_terms: D000328:Adult; D052858:Cystocele / Q000601:surgery*; D003625:Data Collection; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D020407:Internet; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D055502:Secondary Prevention; D053825:Suburethral Slings / Q000706:statistics & numerical data; D013526:Surgical Mesh / Q000706:statistics & numerical data; D014183:Transplantation, Heterologous / Q000706:statistics & numerical data; D014184:Transplantation, Homologous / Q000706:statistics & numerical data; D013520:Urologic Surgical Procedures / Q000379:methods*