A Retrospective Observational Study on the Outcomes and Efficacy of the Manchester Procedure as a Uterine-Sparing Surgery for Uterovaginal Prolapse

Objective: The goal of this study was a retrospective evaluation of the outcomes in patients who underwent the Manchester procedure for uterovaginal prolapse; this procedure was performed for each patient in the Department of Urogynaecology of K.K. Women's and Children's Hospital, Singapore, from November 2002 to July 2015. Materials and Methods: The patients' preoperative demographic parameters, grades of prolapse, and intraoperative details were evaluated. The postoperative complications, recurrence of symptoms or prolapse noted on examination, and pregnancy outcomes were also assessed. Results: Fifty-seven women underwent the Manchester procedure during this time period, of which 55 case notes could be retrieved. The average age and parity of the patients were 41.3 years and 2, respectively. The average duration of the surgery was 46 minutes and the average blood loss was 31.8mL. There were no intraoperative complications. Five patients (9.1%) had excessive bleeding per vaginum within 2 weeks of the procedure and 4 patients (7.3%) had voiding dysfunction postoperatively. There were no long-term complications. Twenty-three of 39 patients (59%) were seen at a 5-year postoperative follow up. On follow-up, 2 patients complained of occasional stress urinary incontinence, but none had recurrences of prolapse noted on examinations. Conclusions: In view of its low complication and prolapse recurrence rates, the Manchester procedure could be considered for women with uterovaginal prolapse who want to conserve their uteri for various reasons.