Objectives:  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.

Conclusion:  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.