MINIMALLY-INVASIVE TRANSOBTURATOR CORRECTION OF CYSTOCELE

Abstract

We present our initial experience with the Perige™ System for correction of prolapse of the anterior vaginal wall. We recruited twenty patients with anterior vaginal prolapse, underwent a prosthetic operation using the Perigee System, which consists of a large-pore, monofilament polypropylene mesh and four lateral arms made of the same material, positioned via the transobturator foramen. This system permits simultaneous correction of central and lateral defects. Prolapse and therapeutic outcome were evaluated using the POP-Q system. The 20 patients were suffering from grade III cystocele. The follow-up was conducted after six weeks, three months, six months, twelve months and eighteen months. After six weeks and three months the cystocele was MInIMally-InVaSIVe correzIone proteSIca tranSoBturator MInIInVaSIVa per VIa correctIon tranSotturatorIa of cyStocele Del cIStocele r Baccichet*, c Braghin, a azzena Obstetrics and GynaecOlOGy Unit, Ospedale civile di cOneGlianO venetO, Ulss 7 *UrOGynaecOlOGy department, Obstetrics and GynaecOlOGy Unit, O.c. cOneGlianO venetO, Ulss 7 Key words: prolapse anterior vaginal wall, cystocele, transobturator foramen, minimally-invasive urogynecological surgery, tension-free technique of mesh, entirely resolved (grade 0) in the 20 patients. After six months the cystocele was resolved (grade 0) in 17 patients, while three had grade I cystocele. After 12 months and 18 months the cystocele remain grade 0 in 16 patients, while four had grade I cystocele. No vascular damage or significant bleeding was observed. Two cases of vaginal erosion and one of de novo urinary incontinence were observed. Our experience appears to show that transobturator prosthetic correction of cystocele represents a safe, effective and reproducible minimally-invasive surgical technique that permits adequate restoration of normal anatomy.