Obstetrics & Gynaecology · Prolapse, Urinary Incontinence and Fistulas

A 42-year-old woman with two normal deliveries has symptomatic stage II uterovaginal prolapse. She desires future fertility. Which surgical procedure is most appropriate?

  • A Manchester repair (Fothergill's operation)
  • B Total abdominal hysterectomy with vault suspension
  • C Le Fort's colpocleisis
  • D Sacrospinous ligament fixation
Correct answer: A. Manchester repair (Fothergill's operation)

Explanation

Manchester repair is the procedure of choice for uterovaginal prolapse in women desirous of retaining the uterus and future fertility. It involves cervical amputation, plication of the cardinal ligaments, anterior colporrhaphy, and posterior colpoperineorrhaphy. Le Fort's colpocleisis is reserved for elderly women not cohabiting. Sacrospinous fixation and hysterectomy nullify fertility.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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