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International Urogynecology Journal

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01-01-2017 | Review Article

The Manchester procedure versus vaginal hysterectomy in the treatment of uterine prolapse: a review

Authors: Cæcilie Krogsgaard Tolstrup, Gunnar Lose, Niels Klarskov

Published in: International Urogynecology Journal | Issue 1/2017

Abstract

Introduction and hypothesis

Uterine prolapse is a common health problem and the number of surgical procedures is increasing. No consensus regarding the surgical strategy for repair of uterine prolapse exists. Vaginal hysterectomy (VH) is the preferred surgical procedure worldwide, but uterus-preserving alternatives including the Manchester procedure (MP) are available. The objective was to evaluate if VH and the MP are equally efficient treatments for uterine prolapse with regard to anatomical and symptomatic outcome, quality of life score, functional outcome, re-operation and conservative re-intervention rate, complications and operative outcomes.

Methods

We systematically searched Embase, PubMed, the Cochrane databases, Clinicaltrials and Clinical trials register using the MeSh terms “uterine prolapse”, “uterus prolapse”, “vaginal prolapse” “pelvic organ prolapse”, “prolapsed uterus”, “Manchester procedure” and “vaginal hysterectomy”. No limitations regarding language, study design or methodology were applied. In total, nine studies published from 1966 to 2014 comparing the MP to VH were included.

Results

The anatomical recurrence rate for the middle compartment was 4–7 % after VH, whereas recurrence was very rare after the MP. The re-operation rate because of symptomatic recurrence was higher after VH (9–13.1 %) compared with MP (3.3–9.5 %) and more patients needed conservative re-intervention (14–15 %) than after MP (10–11 %). After VH, postoperative bleeding and blood loss tended to be greater, bladder lesions and infections more frequent and the operating time longer.

Conclusions

This review is in favour of the MP, which seems to be an efficient and safe treatment for uterine prolapse. We suggest that the MP might be considered a durable alternative to VH in uterine prolapse repair.

Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. Pelvic organ prolapse in the women’s health initiative: gravity and gravidity. Am J Obstet Gynecol. 2002;186(6):1160–6.CrossRefPubMed

Olsen AL, Smith VJ, Bergstrom JO, Colling JCR, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89(4):501–6.CrossRefPubMed

Wu JM, Matthews CA, Conover MM, Pate V, Jonsson FM. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(6):1201–6.CrossRefPubMedPubMedCentral

Elterman DS, Chughtai BI, Vertosick E, Maschino A, Eastham JA, Sandhu JS. Changes in pelvic organ prolapse surgery in the last decade among United States urologists. J Urol. 2014;191(4):1022–7.CrossRefPubMed

Brown JS, Waetjen LE, Subak LL, Thom DH, Van Den Eeden S, Vittinghoff E. Pelvic organ prolapse surgery in the United States, 1997. Am J Obstet Gynecol. 2002;186(4):712–6.CrossRefPubMed

Vanspauwen R, Seman E, Dwyer P. Survey of current management of prolapse in Australia and New Zealand. Aust N Z J Obstet Gynaecol. 2010;50(3):262–7.CrossRefPubMed

Jha S, Moran P. The UK national prolapse survey: 5 years on. Int Urogynecol J. 2011;22(5):517–28.CrossRefPubMed

Oversand SH, Staff AC, Spydslaug AE, Svenningsen R, Borstad E. Long-term follow-up after native tissue repair for pelvic organ prolapse. Int Urogynecol J. 2014;25(1):81–9.CrossRefPubMed

Ünlübilgin E, Sivaslioglu A, Ilhan T, Kumtepe Y, Dölen I. Which one is the appropriate approach for uterine prolapse: Manchester Procedure or vaginal hysterectomy? Turk Klin J Med Sci. 2013;33(2):321–5.

10.

Miedel A, Tegerstedt G, Mörlin B, Hammarström M. A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(12):1593–601.CrossRefPubMed

11.

De Boer TA, Milani AL, Kluivers KB, Withagen MIJ, Vierhout ME. The effectiveness of surgical correction of uterine prolapse: cervical amputation with uterosacral ligament plication (modified Manchester) versus vaginal hysterectomy with high uterosacral ligament plication. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(11):1313–9.CrossRefPubMedPubMedCentral

12.

Iliev VN. Uterus preserving vaginal surgery versus vaginal hysterectomy for correction of female pelvic organ prolapse. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2014;35(1):243–7.

13.

Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA. Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group. Neurourol Urodyn. 1995;14(2):131–9.CrossRefPubMed

14.

van der Vaart CH, de Leeuw JRJ, Roovers J-PWR, Heintz APM. Measuring health-related quality of life in women with urogenital dysfunction: the urogenital distress inventory and incontinence impact questionnaire revisited. Neurourol Urodyn. 2003;22(2):97–104.CrossRefPubMed

15.

Thys SD, Coolen A-L, Martens IR, Oosterbaan HP, Roovers J-PWR, Mol B-W, et al. A comparison of long-term outcome between Manchester Fothergill and vaginal hysterectomy as treatment for uterine descent. Int Urogynecol J. 2011;22(9):1171–8.CrossRefPubMed

16.

Rubin A. Complications of vaginal operations for pelvic floor relaxation. Am J Obstet Gynecol. 1966;95(7):972–4.CrossRefPubMed

17.

Ottesen M, Utzon J, Kehlet H, Ottesen BS. Vaginal surgery in Denmark in 1999–2001. An analysis of operations performed, hospitalization and morbidity. Ugeskr Laeger. 2004;166(41):3598–601.PubMed

18.

Thomas AG, Brodman ML, Dottino PR, Bodian C, Friedman F, Bogursky E. Manchester procedure vs. vaginal hysterectomy for uterine prolapse. A comparison. J Reprod Med. 1995;40(4):299–304.PubMed

19.

Kalogirou D, Antoniou G, Karakitsos P, Kalogirou O. Comparison of surgical and postoperative complications of vaginal hysterectomy and Manchester procedure. Eur J Gynaecol Oncol. 1996;17(4):278–80.PubMed

20.

Dietz V, Koops SES, van der Vaart CH. Vaginal surgery for uterine descent; which options do we have? A review of the literature. Int Urogynecol J. 2008;20(3):349–56.CrossRef

21.

Detollenaere RJ, den Boon J, Vierhout ME, van Eijndhoven HWF. Uterussparende chirurgie versus vaginale hysterectomie als behandeling van descensus uteri. Litteratuuronderzoek Ned Tijdschr Geneeskd. 2011;155:A3623.PubMed

22.

Shull BL, Bachofen C, Coates KW, Kuehl TJ. A transvaginal approach to repair of apical and other associated sites of pelvic organ prolapse with uterosacral ligaments. Am J Obstet Gynecol. 2000;183(6):1365–73, discussion 1373–1374.CrossRefPubMed

23.

Aigmueller T, Dungl A, Hinterholzer S, Geiss I, Riss P. An estimation of the frequency of surgery for posthysterectomy vault prolapse. Int Urogynecol J. 2010;21(3):299–302.CrossRefPubMed

24.

Frick AC, Walters MD, Larkin KS, Barber MD. Risk of unanticipated abnormal gynecologic pathology at the time of hysterectomy for uterovaginal prolapse. Am J Obstet Gynecol. 2010;202(5):507.e1–4.CrossRef

25.

Hanson GE, Keettel WC. The Neugebauer-Le Fort operation. A review of 288 colpocleises. Obstet Gynecol. 1969;34(3):352–7.PubMed

26.

Jones KA. Hysterectomy at the time of colpocleisis: a decision analysis. Int Urogynecol J. 2016;27(5):805–10.CrossRefPubMed

27.

Dietz V. One-year follow-up after sacrospinous hysteropexy and vaginal hysterectomy for uterine descent: a randomized study. Int Urogynecol J. 2010;21(2):209–16.CrossRefPubMed

28.

Lin T-Y. Risk factors for failure of transvaginal sacrospinous uterine suspension in the treatment of uterovaginal prolapse. J Formos Med Assoc. 2005;104(4):249–53.PubMed

29.

Barski D, Otto T, Gerullis H. Systematic review and classification of complications after anterior, posterior, apical, and total vaginal mesh implantation for prolapse repair. Surg Technol Int. 2014;24:217–24.PubMed

30.

Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2013;4:CD004014.

31.

FDA. FDA Public Health Notification: Serious complications associated with transvaginal placement of surgical mesh in repair of pelvic organ prolapse and stress urinary incontinence. 2008.

32.

FDA. FDA Update on serious complications associated with transvaginal placement of surgical mesh for pelvic organ prolapse: FDA Safety Communication. 2011.

33.

Scientific Committee on Emerging and Newly Identified Health Risks, SCENIHR. Opinion on the safety of surgical meshes used in urogynecological surgery. European Commission; 2015.

34.

Frick AC. Attitudes toward hysterectomy in women undergoing evaluation for uterovaginal prolapse. Female Pelvic Med Reconstr Surg. 2013;19(2):103–9.CrossRefPubMed

35.

Korbly NB. Patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse. Am J Obstet Gynecol. 2013;209(5):470–6.CrossRefPubMed

Title: The Manchester procedure versus vaginal hysterectomy in the treatment of uterine prolapse: a review
Authors: Cæcilie Krogsgaard Tolstrup
Gunnar Lose
Niels Klarskov
Publication date: 01-01-2017
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 1/2017
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-016-3100-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Manchester procedure versus vaginal hysterectomy in the treatment of uterine prolapse: a review

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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