A 38-year-old woman with grade II uterovaginal prolapse wants to retain her uterus and complete her family. She has an elongated hypertrophied cervix without significant enterocele. Which operation is most suitable?

• A Sacrouterine ligament plication (Shirodkar modification)
• B Vaginal hysterectomy with pelvic floor repair
• C Le Fort colpocleisis
• D Fothergill (Manchester) operation ✓

Explanation

The Fothergill or Manchester operation treats uterovaginal prolapse while conserving the uterus. Its components are amputation of the elongated cervix, transfixion of the cardinal (Mackenrodt) ligaments in front of the cervix, anterior colporrhaphy, and posterior perineorrhaphy. It is ideal for a young woman wanting future pregnancy, though subsequent deliveries should be by caesarean section to protect the repair. Vaginal hysterectomy removes the uterus, and Le Fort colpocleisis obliterates the vagina, excluding both intercourse and delivery.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.