Ahlfelt states that the only problem in plastic gynecology left unsolved by the gynecologist of the past century is that of permanent cure of cystocele.
That these cases recur after operation is too well known. The late Paul Numde states that all of his cases ended in failure and he had given up operating for that condition. The reason for failure seems to be that the normal support of the bladder has not been sought for and restored, but instead an irrational removal of part of the anterior vaginal wall has been resorted to, which could result only in disappointment and failure.
The support of the bladder may readily be determined in the cadaver by making a suprapubic incision and attempting to push the bladder out through the vulva. It will be found to rest on the anterior vaginal wall to which it is slightly adherent. If the bladder