Manchester Operation Research Articles

Manchester operation of colporrhaphy in the treatment of uterine prolapse

Manchester operation of colporrhaphy in the treatment of uterine prolapse

The so-called Manchester operation

The so-called Manchester operation

The Manchester Operation, with Special Reference to Parturition and Complete Prolapse: A Report of 206 Cases

The Manchester Operation, with Special Reference to Parturition and Complete Prolapse: A Report of 206 Cases

THE SURGICAL TREATMENT OF PROLAPSE OF THE UTERUS

There is no subject in gynecology which can evoke more discussion among gynecologists than the treatment of uterine prolapse. In several clinics in this country vaginal panhysterectomy is done almost routinely to cure this condition; in others the Watkins interposition operation is the standard treatment, in others the Manchester operation is done and in still others extensive vaginal plastic work is combined with some type of intra-abdominal suspension. In general there has been a trend in the past two decades toward doing the entire procedure by the vaginal route unless intrapelvic disease necessitates laparotomy. It is my opinion that one should not approach the subject with a fixed plan of operation. Each case should be judged and treated as an individual problem. In selecting the best operative procedure in an individual case several factors must be taken into consideration. The most important of these factors are: The general physical condition

Fothergill Operation in the Treatment of Genital Prolapse: Bazan, J., and Althabe, O.: Semana méd. 49: 1476, 1942

Fothergill Operation in the Treatment of Genital Prolapse: Bazan, J., and Althabe, O.: Semana méd. 49: 1476, 1942

The Manchester operation: With special reference to its development and the principles involved in its technic

T HE probIems associated with uterine proIapse have heId for the gynecoIogist an interest which has existed over a period of many years. This has resuIted in numerous and definite achievements. Chief among these, is the marked reduction in the occurrence of this condition and the deveIopment of an operative procedure which not onIy restores the proIapsed peIvic organs to their norma position and reIationship, but reestablishes their physiologic function as well. The treatment of uterine proIapse, previous to the period of operative procedure, often proved to be a difficuIt and intricate problem. The retaining pessary, being the soIe means of treatment, was rendered useless when tissue contro1 was inadequate. This fact naturally led to operative attempts towards securing support for the pessary. Some of these were directed toward utihzing the tissues of the anterior vaginal waI1, whiIe others advocated the use of posterior coIporrhaphy. However, neither of these operations proved to be of great value. DonaId of Manchester, appreciative of the inadequacy of these operations as separate procedures, and also recognizing the need of more permanent support without the use of the pessary, decided to combine these operations with amputation of the cervix, and in so doing, accompIished NEW YORK

“Parametrial Fixation” (Manchester operation) for prolapse of the uterus

“Parametrial Fixation” (Manchester operation) for prolapse of the uterus

The treatment of prolapsus uteri, with special reference to the Manchester operation of colporrhaphy

1.1. A combination of anterior and posterior colporrhaphy with amputation of the cervix is the best method of treatment for all cases of prolapsus uteri.2.2. This operation is the best for all patients with this condition whether young or old, parous or nulliparous.3.3. In this series of 549 cases, 529 (95.35 per cent) were cured.4.4. This operation is not a cause of trouble in subsequent labors.5.5. The prolapse may recur after subsequent labors but in less than 25 per cent of cases.6.6. It is necessary to combine an abdominal operation with the colporrhaphy only in those very rare cases where practically no muscular tissue is found in the pelvic floor. In this series it was used only upon two.

The fothergill operation: Dr. F. H. Maier and Dr. W. J. Thudium presented a paper entitled (For original article see page 248)

The fothergill operation: Dr. F. H. Maier and Dr. W. J. Thudium presented a paper entitled (For original article see page 248)

The fothergill operation for the correction of uterine prolapse, with a report of end-results

F OTHERGILL, of Manchester, after years of work, finally developed a standardized operation for the radical cure of uterine prolapse. Those who adopt his technic will have at their disposal a safe, simple and anat,omically correct procedure, which gives uniformly permanent cures in approximately 100 per cent. of the cases. It is quite probable that, this method of surgical treat,ment of prolapse will remain uncha.nged for some time to come, since the permanent results are as good as can be expected of any operative method. The success of Fothergill’s method stands out in marked contrast to t,he earlier procedures. Recurrences were all too frequent after vaginal work alone, although attended by improvement, when combined with abdominal suspension or fixation, and whereas the interposition operation gives a higher percentage of successes than the vaginoabdominal operation, it is limited in its scope and is anatomically and physiological-

A Modification of the Fothergill Operation for Prolapse.

A Modification of the Fothergill Operation for Prolapse.