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Initial Retrospective Analysis Of Efficacy and Safety Of Perigee and Apogee In Patients Undergoing Repair For Pelvic Organ Prolapse
Kurt A McCammon, IV
Eastern Virginia Medical School, Virginia Beach, VA

Introduction: To retrospectively assess outcomes following pelvic organ prolapse (POP) repair with a transobturator anterior prolapse repair system (Perigee; AMS Minnetonka, MN, USA) and/or vaginal vault and posterior repair system (Apogee) using polypropylene mesh or porcine dermis grafts.
Methods: Retrospective chart reviews of 299 patients at 15 sites were conducted; data was available for 298 patients. Parameters included patient demographics, medical history and urogynecologic/lower urinary tract symptoms, pre- and postoperative evaluation of POP and LUTS and information regarding peri- and postoperative surgical complications.
Results: The Perigee system was used in 122 patients (mean age, 61.4 years). Preoperatively, 78.7% of patients had pelvic prolapse > grade III the remaining 21.3% had grade II prolapse. Improvement (grade 0) was seen in 93.3 %; 6.7% achieved grade I. Of the 82 patients (mean age 64.0 years) in the Apogee group, preoperatively, 56.1% had > grade III prolapse and 43.9% had grade II. Of the 95 undergoing repair with both Perigee and Apogee, 63.9% had >grade III prolapse and 36.1% had grade II prolapse. Postoperatively 95.5% had grade 0. Device related complications, were demonstrated in < 1% of patients. Overall mesh exposure rate, 29/298 (9.7%); Perigee 5/121 (4.1%); Apogee, 10/82 (12.2%); and Perigee and Apogee combination, 14/95 (14.7%). 11 patients (37.9%) improved with oral, topical or no treatment; 9 (31.0% required in-office therapy; and 9 (31.0%) required surgical treatment.
Conclusions: POP repair with Perigee and/or Apogee systems with polypropylene or porcine dermis grafts are effective in treating POP with very few postoperative complications.

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