Long-Term Outcomes and Quality of Life After Manchester Procedure for Pelvic Reconstructive Surgery in Women With Cervical Elongation Publisher Pubmed



Deldar Pesikhani M¹ ; Ghanbari Z¹ ; Eftekhar T¹ ; Kazemi M¹ ; Nassiri S¹ ; Sabzi Shahrbabaki F¹ ; Ghaemi M¹ Show Affiliations
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology Published:2023

Abstract

Objective: Native-tissue techniques for Pelvic Organ Prolapse (POP) repairs, such as the Manchester Procedure (MP), have recently been revitalized. However, there are conflicting opinions regarding correcting cervical elongation support by the MP, and the risk of possible poor outcomes and postoperative complications. Therefore, this study aimed to investigate anatomical and patient-reported outcomes during one year after MP. Design: Prospective cohort study. Setting: This study was conducted on women who underwent the MP for cervical elongation between 2010 and 2020. Patients: Women with apical compartment prolapse up to stage 3 due to cervical elongation. Interventions: Manchester Procedure. Measurements: Pre and postoperative evaluations by POP Quantification (POP-Q) system were performed, and patients filled out the quality-of-life questionnaires including Pelvic Floor Distress Inventory Short Form 20 (PFDI-20), and POP/Urinary Incontinence Sexual Questionnaire (PISQ-12) before and 12 months after the procedure. Anatomical outcomes were measured by POP-Q and the changes in POP-related symptoms were evaluated and reported. Main Results: 33 participants were recruited in the study. Significant anatomical improvements were obtained in all compartments after the surgery. After 12 months in POP-Q examination, the mean (±SD) of Ba was changed from +1.82 (±1.71) to −1.18 (±1.50), C was changed from −1.25 (±2.81) to −6 (±1.82), and D from −6.30 (±1.42) to −7.1 (±1.25) respectively (P < 0.001). POP-Q stage 0–1 was obtained inof7% in the apical compartment (C < −1), but only in 45.4% in the anterior compartment (Ba < −1). A significant reduction in symptom scores was obtained for PFDI-20 (P < 0.01) and PISQ-12 (P = 0.011). Conclusions: Our findings suggest that the MP provides adequate apical support with improvement in anatomic and subjective findings for patients with cervical elongation. © 2023 Elsevier B.V.