The aim of the study was to investigate the postoperative effect of abdominal sacrocolpopexy (aSCP) versus vaginal sacrospinal fixation (vssF) on the anterior compartment. In a retrospective study, 25 patients at 24 months following aSCP (group 1) and 28 patients at 60 months following vssF (group 2) were examined and data collected as to vaginal prolapse, recurrent cystocele or stress incontinence, de novo stress incontinence and urge symptoms. In addition, a review of the literature published from 1970 to 2002 was performed. Both methods achieved comparable results. We recorded no recurrent vaginal prolapse in either study group. Moderate to severe cystoceles were found postoperatively in 38 % of group 1 and 43 % of group 2. There was no difference in occurrence of urge symptoms. These results are comparable to those published; however, the published rate of occurring cystoceles is slightly lower (11.6 % following vssF, 21.6 % following aSCP). Both methods are equally successful at achieving a permanent fixation of the vaginal vault. We postulate that higher success rates can only be achieved by a more frequent combination with other operative techniques.