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International Urogynecology Journal

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Open Access 01-11-2009 | Original Article

The effectiveness of surgical correction of uterine prolapse: cervical amputation with uterosacral ligament plication (modified Manchester) versus vaginal hysterectomy with high uterosacral ligament plication

Authors: Tiny A. de Boer, Alfredo L. Milani, Kirsten B. Kluivers, Mariella I. J. Withagen, Mark E. Vierhout

Published in: International Urogynecology Journal | Issue 11/2009

Abstract

Introduction and hypothesis

The objective of this study is to evaluate cervical amputation with uterosacral ligament plication (modified Manchester) and compare it to vaginal hysterectomy with high uterosacral ligament plication procedure with special regard to the middle compartment.

Methods

Consecutive women with pelvic organ prolapse who underwent either vaginal hysterectomy or a modified Manchester procedure were included. Assessments were made preoperatively and at 1-year follow-up, including physical examination with pelvic organ prolapse quantification standardised questionnaires (incontinence impact questionnaire, urogenital distress inventory, and defaecatory distress inventory).

Results

Between 2002 and 2007, 156 patients were included. Ninety-eight patients returned for a 1-year follow-up. In the modified Manchester group, we found no middle compartment recurrence versus two (4%) in the vaginal hysterectomy group. Anterior and posterior compartment prolapse recurrences (stage ≥2) were similar (approximately 50%). Considering operating time and blood loss, modified Manchester was more favourable. There was no difference in the pre- and postoperative subjective scores. The overall functional outcome was acceptable.

Conclusions

We found an excellent performance of both procedures regarding middle compartment recurrences.

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Title: The effectiveness of surgical correction of uterine prolapse: cervical amputation with uterosacral ligament plication (modified Manchester) versus vaginal hysterectomy with high uterosacral ligament plication
Authors: Tiny A. de Boer
Alfredo L. Milani
Kirsten B. Kluivers
Mariella I. J. Withagen
Mark E. Vierhout
Publication date: 01-11-2009
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 11/2009
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-009-0945-3

At a glance: The STEP trials

Springer Medicine

The effectiveness of surgical correction of uterine prolapse: cervical amputation with uterosacral ligament plication (modified Manchester) versus vaginal hysterectomy with high uterosacral ligament plication

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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