International Urogynecology Journal

, Volume 29, Issue 8, pp 1193–1201 | Cite as

The Manchester procedure: anatomical, subjective and sexual outcomes

  • Sissel Hegdahl OversandEmail author
  • Anne C. Staff
  • Ellen Borstad
  • Rune Svenningsen
Original Article


Introduction and hypothesis

Classical native-tissue techniques for pelvic organ prolapse (POP) repairs, such as the Manchester procedure (MP), have been revitalized because of vaginal mesh complications. However, there are conflicting opinions regarding sufficient apical (mid-compartment) support by the MP and concerns about the risk of dyspareunia. The aims of this study were therefore to investigate anatomical and patient-reported outcomes 1 year after MP.


Prospective cohort study of 153 females undergoing an MP for anterior compartment POP between October 2014 and June 2016. Pre- and 1-year postoperative evaluations included POP-Q measurements and the questionnaires Pelvic Floor Distress Inventory Short Form 20 (PFDI-20) and POP/Urinary Incontinence Sexual Questionnaire (PISQ-12).


At 1 year, 97% (148/153) attended the follow-up. Significant anatomical improvements (p < 0.01) were obtained in all compartments. Mean Ba was −1.1 (± 1.4), mean C −5.9 (± 1.7) and mean D −7.0 (± 1.2) at follow-up. Point C ≤ −5 was present in 81.1%. POP-Q stage 0–1 was obtained in 99.3% in the mid-compartment (C < −1), but only in 48.6% in the anterior compartment (Ba < −1). A significant reduction in symptom scores was obtained for PFDI-20 (p < 0.01) and PISQ-12 (p = 0.01). No significant changes were seen in dyspareunia rates (q.5, PISQ-12), but 5.6% reported de novo dyspareunia. Concerning POP symptoms, 96.0% reported being cured or significantly improved.


The Manchester procedure provides adequate apical support, albeit inferior anatomical anterior compartment results, and 96.0% reported being subjectively cured or substantially better at 1-year follow-up, with no significant change in dyspareunia.


Dyspareunia Gynecologic surgical procedures Pelvic organ prolapse Recurrence 



The authors would like to thank Associate Prof. Jon Michael Gran, Biostatistician at OUS and UiO, for support with statistical analyses.

Compliance with ethical standards

Conflicts of interest



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Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  1. 1.Department of GynaecologyOslo University HospitalOsloNorway
  2. 2.Faculty of MedicineUniversity of OsloOsloNorway

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