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

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Abstract

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.

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Abbreviations

POP:

Pelvic organ prolapse

VH:

Vaginal hysterectomy

SSF:

Sacrospinous ligament fixation

MF:

Manchester Fothergill

DSQOL:

Disease-specific quality of life

MMC:

Màxima Medical Centre

JBH:

Jeroen Bosch Hospital

UDI:

Urogenital Distress Inventory

DDI:

Defecatory Distress Inventory

IIQ:

Incontinence Impact Questionnaire

SPSS:

Statistical Package for the Social Sciences

BMI:

Body mass index

SUI:

Stress urinary incontinence

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Authors and Affiliations

  1. Department of Gynaecology and Obstetrics, Maxima Medical Centre, De Run 4600, 5500 MB, Veldhoven, The Netherlands

    Susanne D. Thys, Anne- Lotte Coolen, Ingrid R. Martens, Ben- Willem Mol & Marlies Y. Bongers

  2. Department of Gynaecology and Obstetrics, Academic Medical Centre, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands

    Jan- Paul W. R. Roovers & Ben- Willem Mol

  3. Department of Gynaecology and Obstetrics, Jeroen Bosch Hospital, Kerkstraat 2, ’s Hertogenbosch, 5301 EH, The Netherlands

    Herman P. Oosterbaan

Authors
  1. Susanne D. Thys
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  2. Anne- Lotte Coolen
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  3. Ingrid R. Martens
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  4. Herman P. Oosterbaan
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  5. Jan- Paul W. R. Roovers
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  6. Ben- Willem Mol
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  7. Marlies Y. Bongers
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Correspondence to Susanne D. Thys.

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Thys, S.D., Coolen, A.L., Martens, I.R. et al. A comparison of long-term outcome between Manchester Fothergill and vaginal hysterectomy as treatment for uterine descent. Int Urogynecol J 22, 1171–1178 (2011). https://doi.org/10.1007/s00192-011-1422-3

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  • DOI: https://doi.org/10.1007/s00192-011-1422-3

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