Study design, materials and methods 40 women who underwent anterior colporrhaphy augmented with an acellular dermal matrix (Group I) were compared to 71 women who had anterior colporrhaphy with polypropylene mesh augmentation (Group II). All women with > Stage II pelvic organ prolapse who underwent concomitant bilateral anterior sacrospinous hysteropexy using single permanent sutures placed 1.5 cm medial to the ischial spines on both the right and left sacrospinous ligament (SSL) were included in this analysis. Each SSL suture was also secured to either the allograft or polypropylene mesh to a fixation point on the ipsilateral vaginal apex located 1cm lateral to the cervix on both sides simultaneously suspending the vaginal apices in both groups. The allograft was additionally secured to the arcus tendineus fascia pelvis ATFP bilaterally. The polypropylene mesh was approximated to the ATFP without fixation sutures. Concomitant midurethral slings and posterior repairs were performed as indicated. Wilcoxon two sample tests were used to assess the differences in pre and postoperative changes in POP-Q stage between groups I (hysteropexy with anterior allograft) and group II (hysteropexy with anterior synthetic mesh).