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Manchester Operation: An Effective Treatment for Uterine Prolapse Caused by True Cervical Elongation

Authors
 Yun Jin Park  ;  Mi Kyung Kong  ;  Jinae Lee  ;  Eun Hwa Kim  ;  Sang Wook Bai 
Citation
 YONSEI MEDICAL JOURNAL, Vol.60(11) : 1074-1080, 2019 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2019
Keywords
Clinical outcome ; Manchester operation ; true cervical elongation ; uterine prolapse
Abstract
PURPOSE: Descent of the uterus is a major etiology of uterine prolapse. However, true cervical elongation can cause uterine prolapse without uterine descent. The aim of study was to investigate the clinical outcomes of Manchester operation in patients with uterine prolapse caused by "true cervical elongation," compared with vaginal hysterectomy (VH).

MATERIALS AND METHODS: Medical records of patients who underwent Manchester operation or VH from 2006 to 2015 were reviewed. True cervical elongation was defined on the basis of C point of the Pelvic Organ Prolapse Quantification (POP-Q) system ≥0 and D point ≤-4, as well as estimated cervical length of ≥5 cm. The primary outcome was recurrence of pelvic organ prolapse (POP) evaluated by POP-Q system. The outcomes of two groups were compared after propensity score matching, for age, parity, and preoperative POP-Q stage.

RESULTS: During the study period, 23 patients underwent Manchester operation and 374 patients underwent VH. The recurrence rate of POP (p=0.317) and complication rate were not statistically significant different between the two study groups. Manchester operation exhibited shorter operation time than VH (p=0.033). In subgroup analysis (POP-Q stage III), body mass index [odds ratio (OR)=1.74; 95% confidence interval (CI), 1.08-2.81] and not having concurrent anterior colporrhaphy (OR for concurrent anterior colporrhaphy, 0.06; 95% CI, 0.01-0.75) were identified as significant risk factors for recurrence of POP.

CONCLUSION: The Manchester operation technique seems to be an effective and safe alternative procedure for the treatment of uterine prolapse caused by true cervical elongation, compared with VH.
Files in This Item:
T201904356.pdf Download
DOI
10.3349/ymj.2019.60.11.1074
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Kong, Mi Kyung(공미경)
Park, Yunjin(박윤진)
Bai, Sang Wook(배상욱) ORCID logo https://orcid.org/0000-0001-7724-7552
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173229
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