Which one is the appropriate approach for uterine prolapse: Manchester procedure or vaginal hysterectomy?

Abstract

Objective: To compare the 5-year results of the efficacy of vaginal hysterectomy against Manchester procedure for uterine prolapse. Material and Methods: This study was carried on women with the complaints of uterine prolapse. The patients were randomized into 2 groups using a computer program, and underwent either Manchester procedure (Group 1) or vaginal hysterectomy (Group 2). Both groups were compared in terms of durations of the operations, the length of hospital stay, quality of life (QoL) scores and the recurrences (C point and total vaginal length) at 5 years after operations. Results: Manchester procedure was performed on 49 patients. Vaginal hysterectomy was performed on 45 patients. The mean duration of operation and the length of hospitalization for group 1 and group 2 were 62.4±10.5 minutes and 2.58±0,56 days, and 77.8±13.6 minutes and 2.88±0.63 days, respectively. There were statistically significant differences between groups in terms of the durations of operations (p=0.003) and the length of stay in hospital after the interventions (p=0.042). The postoperative mean of the C point level in group 1 and group 2 were -6.3±0.91 cm and -6±0.97 cm, respectively. There was no statistically significant difference between the groups (p=0.132). The postoperative mean of total vaginal length in groups 1 and 2 were 8,3±0.95 cm and 6.02±0.98 cm, respectively. There was a statistically significant difference between the groups (p=0.016). Postoperative QoL scores improved significantly after both procedures. Conclusion: The Manchester procedure is an efficient alternative of vaginal hysterectomy for the treatment of uterine prolapse © 2013 by Türkiye Klinikleri.