This is a transvaginal-paravaginal technique that simultaneously repairs four defects present in patients with a significant cystocele by:
a) supporting the hypermobile urethra by a sling procedure
b) approximating the cardinal ligaments back to the midline
c) repairing the central defect by approximating the perivesical fascia to the midline and
d) correcting the lateral defect by supporting the the bladder neck and bladder base to the obturator fascia, using mesh.