A 38-year-old woman with two previous normal deliveries has symptomatic uterine prolapse with the cervix reaching the introitus. She desires future fertility. The most appropriate surgical management is:
- A Vaginal hysterectomy with pelvic floor repair
- B Manchester (Fothergill's) operation ✓
- C Abdominal sacrocolpopexy
- D Le Fort's colpocleisis
Correct answer: B. Manchester (Fothergill's) operation
Explanation
Manchester operation (Fothergill's) is the uterine-conserving procedure of choice for prolapse in women desiring fertility. It involves amputation of the elongated cervix, plication of the cardinal ligaments anterior to the cervix, and anterior/posterior colporrhaphy. Vaginal hysterectomy removes the uterus and is not fertility sparing. Le Fort's colpocleisis is for elderly women with no coital function. Sacrocolpopexy is for vault prolapse or recurrent prolapse.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.