Faculty of Medicine, Henrietta Szold Hadassah-Hebrew University School of Nursing, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel.
Arch Gynecol Obstet. 2012 Jun;285(6):1587-92. doi: 10.1007/s00404-011-2195-0. Epub 2011 Dec 31.
This study describes the outcomes of a modified Manchester procedure on the quality of life and sexual functioning of women with elongation of the uterine cervix with or without pelvic organ prolapse (POP).
Data on medical and demographic variables were collected from medical files and then women were invited to for follow-up examination and data collection.
Follow-up data were collected from 53 out of 87 women who underwent reconstructive surgery with modified Manchester procedure (60.9% of the women). Prior the surgery, all women in this sample (n = 53) were medically examined and found to have uterine cervix elongation, 40/53 (75.4%) women also had cystocele, 10/53 women (18.8%) had uterine prolapse and 8/53 women (15.1%) had rectocele (all stages II-IV). On follow-up examination, all the cervical stumps were satisfactorily situated, recurrent cystocele was found among 12/53 women (22.6%) women; 13/53 (24.5%) had rectocele; and none of these women had uterine prolapse. Women with POP (cystocele and rectocele) (24/53) had less operative satisfaction (p = 0.004), lower quality of life (p < 0.05 in 3 out of 8 domains), and poorer sexual function (p = 0.03) compared to women without POP (29/53).
The modified Manchester procedure including reconstructive surgery for women with cervix elongation, with or without POP, prevented recurrent uterine prolapse and was well received in terms of patient's satisfaction, quality of life, and sexual function.
本研究描述了改良曼彻斯特手术对伴有或不伴有盆腔器官脱垂（POP）的宫颈延长的女性生活质量和性功能的影响。
从病历中收集了与医疗和人口统计学变量相关的数据，随后邀请女性进行随访检查和数据收集。
在接受改良曼彻斯特手术重建的 87 名女性中有 53 名（60.9%）完成了随访。在手术前，该样本中的所有女性（n=53）均接受了医学检查，发现有宫颈延长，40/53（75.4%）名女性还患有膀胱膨出，10/53 名女性（18.8%）患有子宫脱垂，8/53 名女性（15.1%）患有直肠膨出（均为 II-IV 期）。在随访检查中，所有宫颈残端位置均满意，12/53 名（22.6%）女性出现复发性膀胱膨出；13/53 名（24.5%）女性出现直肠膨出；且无女性出现子宫脱垂。有 POP（膀胱膨出和直肠膨出）的女性（24/53）手术满意度较低（p=0.004），生活质量下降（8 个领域中有 3 个下降，p<0.05），性功能较差（p=0.03），与无 POP 的女性（29/53）相比。
改良曼彻斯特手术（包括针对宫颈延长伴或不伴 POP 的重建手术）可预防复发性子宫脱垂，在患者满意度、生活质量和性功能方面均获得了良好的效果。
