AI Article Synopsis
- The Manchester repair is a surgical procedure for uterovaginal prolapse aimed at preserving the uterus, initially developed in the UK in 1908 and gaining traction in Europe while being less commonly performed in the USA.
- The case presented involves a 39-year-old woman with a grade 2 cystocele and uterine descent, who underwent the procedure to address her symptoms without removing her uterus.
- The technique includes mobilizing surrounding tissues, amputating the cervix, and using sutures to secure it in place, resulting in effective uterine positioning and promising long-term outcomes.
Article Abstract
Objective: The Manchester repair, developed in the UK by Donald, described in 1908, and later modified by Fothergill, is a well-studied and proven surgical treatment for uterovaginal prolapse when uterine preservation is desired. This operation is currently not widely performed in parts of the world (USA) but is becoming increasing popular in Europe. The objective of this video is to demonstrate our surgical technique and recommendations for successful completion of the procedure.
Methods: This patient is a 39-year-old woman with two previous vaginal deliveries who presented with a 1-year history of vaginal protrusion. She had no urinary or bowel symptoms. On examination, she had a grade 2 cystocele and uterine descent. She desired surgical management of her uterovaginal prolapse but wished to retain her uterus. The procedure involves mobilizing the vagina and bladder off the cervix and uterosacral cardinal ligament complex anteriorly and laterally. The cervix is then amputated. The ligaments are clamped, cut, and ligated and attached to the anterior cervical remnant with an overlapping suture. This pulls the cervix backward into the pelvis and results in anteversion of the uterus. A posterior and then anterior Sturmdorf suture is used to reconstruct the cervix by covering the amputated cervix with vaginal mucosa.
Conclusion: The Manchester repair is an operation worth considering in patients where preservation of the uterus is desired. It uses native tissue and has a low complication rate and good long-term results.
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| http://dx.doi.org/10.1007/s00192-017-3284-9 | DOI Listing |
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