title: Prospective study of the Perigee™ system for treatment of cystocele - our five-year experience.
abstract: OBJECTIVE
  The Perigee™ transobturator cystocoele repair system (AMS) was designed and first used in Townsville, Australia. In this study, we are reporting our five-year experience with the Perigee™ system in the management of cystocoele stage III and above.
  
  
  METHODS
  Women who underwent surgery with the Perigee™ system between March 2004 and June 2008 were reviewed. Women who consecutively presented to our clinic with a stage III cystocoele or above were given information regarding the Perigee™ mesh surgery. Those who consented were included in our study. The study involved a POPQ assessment pre- and post-operatively at six weeks, three months, six months, 12 months and subsequently biannually.
  
  
  RESULTS
  A total of 376 women underwent surgery with the Perigee™ system between March 2004 and June 2008, of which 26 were lost to follow-up. The anatomical success rate for the device was 94.3%, and there were no life-threatening complications with the procedure. 39 (11.1%) of women were found to have small mesh extrusion through the vagina, and 20 (5.7%) had recurrence of stage II cystocoele. Of the subset of women analysed, 45.1% reported no sexual dysfunction, 40.9% reported improvement in sexual function, while 4.1% reported worsening of dyspareunia.
  
  
  CONCLUSIONS
  In this five-year experience, the Perigee™ system is deemed safe with an acceptable recurrence risk rate and complication rate. Further randomised controlled trials comparing Perigee™ system with traditional anterior colporrhaphy should be performed to evaluate mesh-based surgery safety and efficacy for level one evidence.
authors.affiliation: Department of Obstetrics and Gynaecology, Division of Urogynaecology, The Townsville Hospital, Queensland, Australia.
authors.forename: Ajay
authors.initials: A
authors.lastname: Rane
authors.forename: Jay
authors.initials: J
authors.lastname: Iyer
authors.forename: Kurinji
authors.initials: K
authors.lastname: Kannan
authors.forename: Audrey
authors.initials: A
authors.lastname: Corstiaans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D052858:Cystocele / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D053825:Suburethral Slings; D013526:Surgical Mesh; D014596:Uterine Prolapse / Q000601:surgery*; D014621:Vagina / Q000601:surgery