A comparison of long-term outcome between Manchester Fothergill and vaginal hysterectomy as treatment for uterine descent

• Published in: International Urogynecology Journal Vol. 22; no. 9; pp. 1171 - 1178
• Main Authors: Thys, Susanne D., Coolen, Anne- Lotte, Martens, Ingrid R., Oosterbaan, Herman P., Roovers, Jan- Paul W. R., Mol, Ben- Willem, Bongers, Marlies Y.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01-09-2011; Springer Nature B.V
• Subjects: Aged; Blood Loss, Surgical; Female; Follow-Up Studies; Gynecology; Humans; Hysterectomy, Vaginal; Kaplan-Meier Estimate; Medicine; Medicine & Public Health; Middle Aged; Organ Sparing Treatments - methods; Original Article; Proportional Hazards Models; Quality of Life; Recurrence; Reoperation; Retrospective Studies; Surveys and Questionnaires; Time Factors; Treatment Outcome; Urology; Uterine Prolapse - surgery; Manchester Fothergill; Recurrence; Vaginal hysterectomy; Pelvic organ prolapse; Apical compartment
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-011-1422-3

Introduction and hypothesis
The objective of this study was to compare the Manchester Fothergill (MF) procedure with vaginal hysterectomy (VH) as surgical treatment of uterine descent.
Methods
Consecutive patients who underwent MF were matched for prolapse grade, age and parity to consecutive patients treated with VH. Evaluated outcomes included functional outcome, morbidity, recurrence of pelvic organ prolapse (POP) and sexual function. Follow-up was performed using validated questionnaires.
Results
We included 196 patients (98 patients per group). The response rate after a follow-up of 4–9 years was 80%. We found no differences in functional outcome and recurrence rates of POP between groups. Blood loss was significantly less and operating time was significantly shorter in the MF group. However, incomplete emptying of the bladder was more common in the MF group.
Conclusions
The MF procedure is equally effective to the VH and should be considered as a surgical option that allows preservation of the uterus.