Perigee >>
One of the most common complications seen is extrusion of the graft through the vaginal skin. This can occur early with poor healing or later with poor tissue health and has been seen in 2% to 8% of patients. This is considered a minor complication and many times will heal on its own, however if it does not and the graft is exposed, this area will need excised and repaired. This sometimes can even be completed in the office.
Perigee Figure: 1 |
Atlanta Urogynecology Experience
Dr. Moore and Miklos have been performing anterior wall grafts for greater than 5 years and the transobturator Perigee procedure for more than 2 years now. They have once again been world leaders in this new minimally invasive technology to treat anterior wall prolapse (cystocele). They have been part of the United States multi-center trial evaluating and collecting research on the initial patients implanted with the procedure (Dr. Moore is principal investigator of this U.S. trial directing prominent sites from all over the US including the Cleveland Clinic and Harvard). They have taught surgeons from all over the world and operated in Sweden, Finland, Spain, Italy, Greece, Turkey, Chile and Russia demonstrating the technique. Dr. Moore has presented their research in the U.S. and internationally in Copenhagen, Montreal, Argentina and will be traveling to Greece and S. Africa in 2006 to operate and present research.
More Information
To date Dr. Miklos and Moore have seen the same excellent short term clinical success that the Europeans and Australians have experienced. Results in the literature show that grafts have approximately 90% cure rate and the Perigee procedure has been shown to be consistent with this. Dr. Moore and Miklos have not had any patients complain of postoperative pain in the area of the adductor muscles of the thigh, and no failures have occurred to date (however these are short term results and unfortunately NO surgery will ever be 100% effective). No patients have had any nerve injury or major complications. The procedure takes less than 30 minutes to perform and can be completed under local or regional anesthesia. They have found this procedure to be very useful in patients with failed previous procedures, patients with previous retropubic surgery (such as Burch or Paravaginal repair), and in patients that are older or have large or severe prolapse. They also have found this approach useful in obese patients and women with retropubic scarring, in whom retropubic needle passage can be a challenge. This system will not treat urinary leakage, therefore if stress incontinence is an issue for a patient, this must be treated with concomitant sling (such as Monarc TOT sling), which can easily be completed at the same time.
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