A 34-year-old woman has second degree uterine prolapse with elongation of the cervix and an enterocele. She has completed her family but strongly wishes to retain her uterus. The most appropriate operation is:
- A Fothergill's (Manchester) operation ✓
- B Vaginal hysterectomy with pelvic floor repair
- C Sacrocolpopexy
- D Colpocleisis
Correct answer: A. Fothergill's (Manchester) operation
Explanation
The Fothergill or Manchester operation amputates the elongated cervix, shortens the transverse cervical ligaments (Mackenrodt), and performs anterior colporrhaphy with levator plication. It corrects prolapse while preserving the uterus, making it ideal for a woman who desires uterine conservation. Vaginal hysterectomy removes the uterus, sacrocolpopexy is for vault prolapse, and colpocleisis obliterates the vagina and is reserved for elderly women unfit for longer surgery.
Reference: Shaw's Textbook of Operative Gynaecology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.