Background
There is little information on the effectiveness of laparoscopic techniques for native tissue repair of cystocoele.

Aim
To assess the long‐term outcome of laparoscopic cystocoele repair.

Methods
Two hundred and twenty‐three women with symptomatic pelvic organ prolapse underwent laparoscopic paravaginal repair and treatment of associated conditions. Women were assessed pre‐operatively and postoperatively at 6 weeks, 6 months, 12 months and then annually or biannually with pelvic organ prolapse quantification (POPQ) and subjective assessment at each visit.

Results
Median follow‐up was 5.2 years (range: 1–12 years) with 140 women (63%) followed for at least 5 years. During follow‐up, 79% of women developed prolapse of at least POPQ stage 2 in one or more compartments and 58% became symptomatic again. Overall, 48% underwent further prolapse surgery, but only 24% of women had an anterior prolapse beyond the hymen. Thirty per cent eventually had a further cystocoele repair.

Conclusion
Long‐term follow‐up of laparoscopic cystocoele repair shows that cystocoeles are difficult to repair successfully.