Manchester-Fothergill Procedure Research Articles

Evaluation of suture material used in anterior colporrhaphy and the risk of recurrence.

The wide variety of suture material used in colporrhaphy shows a lack of consensus on the optimal choice. The evidence guiding the choice of suture material is scant. The aim of this study was to investigate the effects of rapid versus slowly absorbable suture on risk of recurrence after native tissue anterior colporrhaphy. This longitudinal cohort study was performed secondary to a previously publishedstudy on pelvic organ prolapse recurrence after the Manchester-Fothergill procedure versus vaginal hysterectomy. Data were collected from four Danish databases and corresponding electronic medical records. In this study, women having had anterior colporrhaphy performed were included. Suture materials were divided in three groups: rapid absorbable multifilament suture (RAMuS), rapid absorbable monofilament suture (RAMoS) and slowly absorbable monofilament suture (SAMoS). The main outcome was recurrence of prolapse in the anterior compartment. A total of 462 women were included in this study. No significant difference in recurrence was found among the three suture groups. However, a non-significant tendency towards a higher risk of recurrence in the RAMoS group [HR 2.14 (0.75-6.10) p = 0.16] compared to the RAMuS group was observed. In this study, the use of rapid absorbable multifilament suture compared to slowly absorbable monofilament suture does not seem to lead to a higher risk ofrecurrence after anterior colporrhaphy.

Development of Cervical and Uterine Malignancies During Follow-Up After Manchester–Fothergill Procedure

Objective: This study was conducted to assess the risk of cervical or uterine malignancy development following pelvic organ prolapse (POP) surgery using the Manchester–Fothergill procedure, with th...

19: Modified Manchester-Fothergill procedure for pelvic organ prolapse in a patient with spina bifida

19: Modified Manchester-Fothergill procedure for pelvic organ prolapse in a patient with spina bifida

Kehamilan Pasca Tindakan Manchester Fothergill

Pregnancy after a manchester fothergill action is rare, occurring 1-10,000 post-action. post- manchester fothergill pregnancy can cause premature labor, spontaneous abortion, fetal death, maternal urinary complaints, and sepsis. Case of a 34-year-old female patient, G3P1A1L1 37-38 weeks of term parturient latent phase of first stage + once previous cesarean section + history of manchester fothergill. Previous history of childbirth the patient gave birth through cesarean section and term, the birth weight of children 3200 gr. The second pregnancy the patient suffered a miscarriage at 13-14 weeks gestation and found cervical elongation, then the patient was performed cervical reconstruction with the manchester fothergill procedure after the patient received his normal menstrual cycle. after 2 years later the patient came pregnant with a gestational age of 9 months with complaints of low back pain in the placenta. The conclusion of this case of pregnancy after the manchester fothergill action is a rare condition. pelvic organ prolapse and cervical elongation in pregnancy are conditions to be aware of, therefore early diagnosis is very important for smooth pregnancy. individual approach depends on gestational age, the severity of the prolapse is a matter that must be considered for the choice of delivery. prevention of complications can determine the success of a pregnancy. it must also be concluded that prolapse is not a disease of the elderly. Keywords: cervical elongation, Manchester Fothergill

Kehamilan Pasca Tindakan Manchester Fothergill

Pregnancy after a manchester fothergill action is rare, occurring 1-10,000 post-action. post- manchester fothergill pregnancy can cause premature labor, spontaneous abortion, fetal death, maternal urinary complaints, and sepsis. Case of a 34-year-old female patient, G3P1A1L1 37-38 weeks of term parturient latent phase of first stage + once previous cesarean section + history of manchester fothergill. Previous history of childbirth the patient gave birth through cesarean section and term, the birth weight of children 3200 gr. The second pregnancy the patient suffered a miscarriage at 13-14 weeks gestation and found cervical elongation, then the patient was performed cervical reconstruction with the manchester fothergill procedure after the patient received his normal menstrual cycle. after 2 years later the patient came pregnant with a gestational age of 9 months with complaints of low back pain in the placenta. The conclusion of this case of pregnancy after the manchester fothergill action is a rare condition. pelvic organ prolapse and cervical elongation in pregnancy are conditions to be aware of, therefore early diagnosis is very important for smooth pregnancy. individual approach depends on gestational age, the severity of the prolapse is a matter that must be considered for the choice of delivery. prevention of complications can determine the success of a pregnancy. it must also be concluded that prolapse is not a disease of the elderly. Keywords: cervical elongation, Manchester Fothergill

Trends in apical prolapse surgery between 2010 and 2016 in Denmark.

Pelvic organ prolapse is a common diagnosis. Today there is no consensus on the ideal operation technique for apical prolapse. Vaginal hysterectomy with suspension of the vaginal cuff is the most frequently used, but the popularity of uterus-preserving techniques is increasing. The aim of this study was to describe trends in surgical techniques used to treat primary apical prolapse in Danish hospitals. Data were obtained from the Danish Urogynecological Database and included women with primary prolapse surgery in the apical compartment operated in Denmark 2010-2016. Public hospital departments were divided into three categories according to degree of urogynecological specialization: high level, moderate level, and no specialization. The number of vaginal hysterectomies decreased and the number of uterus-preserving operations increased from 2010 to 2016. The proportion of uterus-preserving techniques versus vaginal hysterectomy differed substantially between different hospital types. At departments with high and moderate levels of specialization, uterus-preserving techniques increased during the period, accounting for nearly 90% and 40%, respectively, in 2016, while decreasing to < 35% for departments with no specialization. Three of the four departments with high-level specialization preferred the Manchester-Fothergill procedure, while one preferred sacrospinous hysteropexy. Only 2.3% of all procedures were performed at private hospitals. The proportion of uterus-preserving techniques to treat apical prolapse increased from 2010 to 2016. However, there is a wide variation in practice at the different hospitals. An agreement on uterus-preserving techniques has not been reached.

Manchester–Fothergill procedure versus vaginal hysterectomy with uterosacral ligament suspension: an activity-based costing analysis

Pelvic organ prolapse (POP) is a common diagnosis that imposes high and ever-growing costs to the healthcare economy. Numerous surgical techniques for the treatment of POP exist, but there is no consensus about which is the ideal technique for treating apical prolapse. The aim of this study was to estimate hospital costs for the most frequently performed operation, vaginal hysterectomy with uterosacral ligament suspension (VH) and the uterus-preserving Manchester-Fothergill procedure (MP), when including costs of postoperative activities. The study was based on a historical matched cohort including 590 patients (295 pairs) who underwent VH or MP during 2010-2014 owing to apical prolapse. The patients were matched according to age and preoperative prolapse stage and followed for a minimum of 20months. Data were collected from four national registries and electronic medical records. Unit costs were obtained from relevant departments, hospital administration, calculated, or estimated by experts. The hospital perspective was applied for costing the resource use. Total costs for the first 20months after operation were 3,514 € per VH patient versus 2,318 € per MP patient. The cost difference between the techniques was 898 € (95% confidence interval [CI]: 818-982) per patient when analyzing the primary operation only and 1,196 € (CI: 927-1,465) when including subsequent activities within 20months (p < 0.0001). The MP is substantially less expensive than the commonly used VH from a 20-month time perspective. Healthcare costs can be reduced by one third if MP is preferred over VH in the treatment of apical prolapse.

The Manchester-Fothergill procedure versus vaginal hysterectomy with uterosacral ligament suspension: a matched historical cohort study

This study compares vaginal hysterectomy with uterosacral ligament suspension (VH) with the Manchester-Fothergill procedure (MP) for treating pelvic organ prolapse (POP) in the apical compartment. Our matched historical cohort study is based on data from four Danish databases and the corresponding electronic medical records. Patients with POP surgically treated with VH (n = 295) or the MP (n = 295) in between 2010 and 2014 were matched for age and preoperative POP stage in the apical compartment. The main outcome was recurrent or de novo POP in any compartment. Secondary outcomes were recurrent or de novo POP in each compartment and complications. The risk of recurrent or de novo POP in any compartment was higher after VH (18.3%) compared with the MP (7.8%) (Hazard ratio, HR = 2.5, 95% confidence interval (CI): 1.3-4.8). Recurrence in the apical compartment occurred in 5.1% after VH vs. 0.3% after the MP (hazard ratio (HR) = 10.0, 95% confidence interval (CI) 1.3-78.1). In the anterior compartment, rates of recurrent or de novo POP were 11.2% after VH vs. 4.1% after the MP (HR = 3.5, 95% CI 1.4-8.7) and in the posterior compartment 12.9% vs. 4.7% (HR = 2.6, 95% CI 1.3-5.4), respectively. There were more perioperative complications (2.7 vs. 0%, p = 0.007) and postoperative intra-abdominal bleeding (2 vs. 0%, p = 0.03) after VH. This study shows that the MP is superior to VH; if there is no other indication for hysterectomy, the MP should be preferred to VH for surgical treatment of POP in the apical compartment.

The outcome of Manchester–Fotergill operation for uterine decensus repair: a single center experience

The aim of this study was to evaluate the clinical characteristics, peri- and post-operative outcomes, and clinical effectiveness of the Manchester-Fothergill (MF) procedure for uterine descensus as a uterine-sparing surgery. In this study, 49 patients underwent the MF procedure as a uterine-sparing surgery for uterine descensus during 2008-2012 in the Department of Urogynecology at Kanuni Sultan Süleyman Research and Teaching Hospital, Istanbul, Turkey. Medical records and follow-up data were collected from 24 of the 49 patients (48.9 %). The mean age was 49.3 ± 9.1 years, and parity 3.6 ± 1.5; 41.6 % were post-menopausal; 6 patients (25 %) had grade II, and 18 (75 %) had grade III uterine prolapse; 95.8 % had associated cystoceles, and 79.1 % had associated rectoceles; 66.6 % complained of urinary incontinence. On follow-up examination, the cervical stumps were satisfactorily situated in 23 of 24 patients, and recurrent prolapse was seen in 1 patient (4.1 %). Bladder perforation was repaired at the time of the operation in 1 patient, and one complained of post-operative urinary retention. The MF procedure is a viable option to surgically correct uterine descent while preserving the uterus to treat recurrent prolapse with a low complication rate and low morbidity.

Surgical management of pelvic organ prolapse and uterine descent in the Netherlands

To evaluate current practice in the surgical treatment of uterine descent among members of the Dutch Urogynecological Society and to analyze possible trends in the surgical treatment of pelvic organ prolapse in the Netherlands during the last decade. A questionnaire, including case scenarios, was sent to the members of the Dutch Urogynecological Society. Using a nationwide registry from the Netherlands, we assessed the number and type of surgical procedures performed for pelvic organ prolapse between 1997 and 2009. The response rate was 73%, with 161 questionnaires completed. Vaginal hysterectomy, sacrospinous hysteropexy, and the Manchester Fothergill procedure were the most frequently performed surgical interventions for uterine descent. In the case of lower stage uterine descent, uterus preservation was preferred, but in the case of higher stage there was wide variation. Two thirds of the respondents stated that in recent years they tended to save the uterus more often. The registered number of hospital admissions for uterine descent increased by 30% between 1997 and 2009 and the number of surgical procedures almost doubled. The number of vaginal hysterectomies performed because of uterine descent increased by only 15% in this period. In the Netherlands, surgical policy in the case of uterine descent is very variable, with no clear preference for either hysterectomy or uterus preservation. There was a high increase in hospital admissions and pelvic organ prolapse procedures in the last decade. The number of vaginal hysterectomies performed because of uterine descent did not follow this change, which reflects a trend toward preserving the uterus.

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

The objective of this study was to compare the Manchester Fothergill (MF) procedure with vaginal hysterectomy (VH) as surgical treatment of uterine descent. 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. 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. The MF procedure is equally effective to the VH and should be considered as a surgical option that allows preservation of the uterus.