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International Urogynecology Journal

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02.08.2016 | Review Article

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

verfasst von: Cæcilie Krogsgaard Tolstrup, Gunnar Lose, Niels Klarskov

Erschienen in: International Urogynecology Journal | Ausgabe 1/2017

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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.

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Titel: The Manchester procedure versus vaginal hysterectomy in the treatment of uterine prolapse: a review
verfasst von: Cæcilie Krogsgaard Tolstrup
Gunnar Lose
Niels Klarskov
Publikationsdatum: 02.08.2016
Verlag: Springer London
Erschienen in: International Urogynecology Journal / Ausgabe 1/2017
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-016-3100-y

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Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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