Which of the following correctly describes the components of the Manchester (Fothergill) operation?
- A Vaginal hysterectomy with high uterosacral ligament suspension
- B Amputation of the cervix, plication of the cardinal ligaments, anterior colporrhaphy and colpoperineorrhaphy ✓
- C Attachment of the vaginal vault to the sacrospinous ligament via a mesh graft
- D Approximation of the paravaginal tissues to Cooper's ligament through a retropubic approach
Correct answer: B. Amputation of the cervix, plication of the cardinal ligaments, anterior colporrhaphy and colpoperineorrhaphy
Explanation
The Manchester operation conserves the uterus and consists of amputation of the elongated cervix, plication of the cardinal (Mackenrodt) ligaments in front of the cervix, anterior colporrhaphy and posterior colpoperineorrhaphy. It suits women with uterine prolapse with cervical hypertrophy or elongation who wish to retain the uterus. Option D describes the Burch colposuspension, which is an anti-incontinence procedure, while options A and C are vault support procedures that remove or bypass the uterus.
Reference: Shaw's Textbook of Gynaecology, 18th ed.
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