Abstract
To demonstrate the anatomy and surgical technique of mesh from above (laparoscopically) and below (vaginally) for recurrent cystocele in conjunction with uterine prolapse. We present a minimally invasive alternative to hysterectomy with complete reconstruction with the technique of cystocele repair with anterior wall mesh via a transobturator approach vaginally (Perigee procedure) combined with a laparoscopic uterine suspension with mesh sacral-uteropexy. Utilizing this approach, the cystocele, anterior apical enterocele, uterine prolapse and high rectocele are treated with a procedure that is minimally invasive, restores normal anatomy and avoids the need for hysterectomy.
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