[Transobturator correction of cystocele].
OBJECTIVE
We present our initial experience with the Perigee system for anterior vaginal wall prolapses repair.


METHODS
15 patients with anterior vaginal wall prolapse (mean age: 62 years old) underwent implanted with Perigee system which is composed by a mesh for correcting central defect and four self-attached horns for correcting lateral defect. The implanted procedure consist of four steps: 1) lateral vaginal wall dissection as far as isquiopubic branch; 2) performance of two upper marks at genitofemoral fold and two lower marks at 2 cm laterally and 3 cm lower; 3) insertion of the upper needles parallel to the isquiopubic branch and connection with the mesh's "arms" plus insertion of the lower needles vertically and connection with mesh's "legs"; 4) to adjust the mesh free tension. The system POP-Q was used as an objective measure of correction rate.


RESULTS
Preoperatively, the point Aa was 0.09. After 6 weeks and three months postoperatively was -3.00 and -2.73 respectively. Preoperatively, the point Ba was 1.73. After 6 weeks and three months postoperatively was -2.82 and -2.82 respectively. No major complications were presented. No vascular damage or significant bleeding was observed.


CONCLUSIONS
The transobturator correction of cystocele is an attractive alternative. The initial good outcome may be expected to be long lasting.
Palma
P
P
Servicio de Uroginecología, Universidade Estadual de Campinas-UNICAMP, Campinas, Brasil.
Rane
A
A
Riccetto
C
C
Herrmann
V
V
Dambros
M
M
Tarazona
A
A
D000328:Adult; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008875:Middle Aged; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D014621:Vagina / Q000601:surgery