Deldar Pesikhani Maryam, Ghanbari Zinat, Eftekhar Tahereh, Kazemi Maryam, Nassiri Saina, Sabzi Shahrbabaki Farideh, Ghaemi Marjan
Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Eur J Obstet Gynecol Reprod Biol. 2023 Oct;289:152-157. doi: 10.1016/j.ejogrb.2023.08.371. Epub 2023 Aug 21.
Native-tissue techniques for Pelvic Organ Prolapse (POP) repairs, such as the Manchester Procedure (MP), have recently been revitalized. However, there are conflicting opinions regarding correcting cervical elongation support by the MP, and the risk of possible poor outcomes and postoperative complications. Therefore, this study aimed to investigate anatomical and patient-reported outcomes during one year after MP.
Prospective cohort study.
This study was conducted on women who underwent the MP for cervical elongation between 2010 and 2020.
Women with apical compartment prolapse up to stage 3 due to cervical elongation.
Manchester Procedure.
Pre and postoperative evaluations by POP Quantification (POP-Q) system were performed, and patients filled out the quality-of-life questionnaires including Pelvic Floor Distress Inventory Short Form 20 (PFDI-20), and POP/Urinary Incontinence Sexual Questionnaire (PISQ-12) before and 12 months after the procedure. Anatomical outcomes were measured by POP-Q and the changes in POP-related symptoms were evaluated and reported.
33 participants were recruited in the study. Significant anatomical improvements were obtained in all compartments after the surgery. After 12 months in POP-Q examination, the mean (±SD) of Ba was changed from +1.82 (±1.71) to -1.18 (±1.50), C was changed from -1.25 (±2.81) to -6 (±1.82), and D from -6.30 (±1.42) to -7.1 (±1.25) respectively (P < 0.001). POP-Q stage 0-1 was obtained inof7% in the apical compartment (C < -1), but only in 45.4% in the anterior compartment (Ba < -1). A significant reduction in symptom scores was obtained for PFDI-20 (P < 0.01) and PISQ-12 (P = 0.011).
Our findings suggest that the MP provides adequate apical support with improvement in anatomic and subjective findings for patients with cervical elongation.
骨盆器官脱垂（POP）修复的自体组织技术，如曼彻斯特手术（MP），最近得以复兴。然而，对于MP纠正宫颈延长支撑以及可能出现不良结局和术后并发症的风险，存在相互矛盾的观点。因此，本研究旨在调查MP术后一年的解剖学和患者报告结局。
前瞻性队列研究。
本研究针对2010年至2020年间因宫颈延长而接受MP的女性进行。
因宫颈延长导致顶端盆腔器官脱垂达3期的女性。
曼彻斯特手术。
采用盆腔器官脱垂定量（POP-Q）系统进行术前和术后评估，患者在手术前和术后12个月填写生活质量问卷，包括盆底困扰量表简表20（PFDI-20）和盆腔器官脱垂/尿失禁性功能问卷（PISQ-12）。通过POP-Q测量解剖学结局，并评估和报告与盆腔器官脱垂相关症状的变化。
本研究招募了33名参与者。术后所有盆腔均获得了显著的解剖学改善。在POP-Q检查12个月后，Ba的平均值（±标准差）从+1.82（±1.71）变为-1.18（±1.50），C从-1.25（±2.81）变为-6（±1.82），D从-6.30（±1.42）变为-7.1（±1.25）（P<0.001）。顶端盆腔（C<-1）有7%达到POP-Q 0-1期，但前盆腔（Ba<-1）仅为45.4%。PFDI-20（P<0.01）和PISQ-12（P=0.011）的症状评分显著降低。
我们的研究结果表明，MP为宫颈延长患者提供了足够的顶端支撑，改善了解剖学和主观结果。
