Women's well-being after Manchester procedure for pelvic reconstruction with uterine preservation: a follow-up study.
OBJECTIVE
This study describes the outcomes of a modified Manchester procedure on the quality of life and sexual functioning of women with elongation of the uterine cervix with or without pelvic organ prolapse (POP).


METHODS
Data on medical and demographic variables were collected from medical files and then women were invited to for follow-up examination and data collection.


RESULTS
Follow-up data were collected from 53 out of 87 women who underwent reconstructive surgery with modified Manchester procedure (60.9% of the women). Prior the surgery, all women in this sample (n = 53) were medically examined and found to have uterine cervix elongation, 40/53 (75.4%) women also had cystocele, 10/53 women (18.8%) had uterine prolapse and 8/53 women (15.1%) had rectocele (all stages II-IV). On follow-up examination, all the cervical stumps were satisfactorily situated, recurrent cystocele was found among 12/53 women (22.6%) women; 13/53 (24.5%) had rectocele; and none of these women had uterine prolapse. Women with POP (cystocele and rectocele) (24/53) had less operative satisfaction (p = 0.004), lower quality of life (p < 0.05 in 3 out of 8 domains), and poorer sexual function (p = 0.03) compared to women without POP (29/53).


CONCLUSIONS
The modified Manchester procedure including reconstructive surgery for women with cervix elongation, with or without POP, prevented recurrent uterine prolapse and was well received in terms of patient's satisfaction, quality of life, and sexual function.
Faculty of Medicine, Henrietta Szold Hadassah-Hebrew University School of Nursing, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel. michall2@hadassah.org.il
Michal
M
Liebergall-Wischnitzer
Assaf
A
Ben-Meir
Orly
O
Sarid
Julie
J
Cwikel
Yuval
Y
Lavy
D000328:Adult; D000368:Aged; D052858:Cystocele / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011788:Quality of Life; D020047:Rectocele / Q000601:surgery; D019529:Sexuality; D016896:Treatment Outcome; D014599:Uterus / Q000601:surgery*