Sissel Hegdahl Oversand1,2, Anne C Staff3,4, Ellen Borstad3, Rune Svenningsen3. 1. Department of Gynaecology, Oslo University Hospital, Ulleval, Pb 4956 Nydalen, 0424, Oslo, Norway. sisseloversand@gmail.com. 2. Faculty of Medicine, University of Oslo, Oslo, Norway. sisseloversand@gmail.com. 3. Department of Gynaecology, Oslo University Hospital, Ulleval, Pb 4956 Nydalen, 0424, Oslo, Norway. 4. Faculty of Medicine, University of Oslo, Oslo, Norway.
Abstract
INTRODUCTION AND HYPOTHESIS: Classical native-tissue techniques for pelvic organ prolapse (POP) repairs, such as the Manchester procedure (MP), have been revitalized because of vaginal mesh complications. However, there are conflicting opinions regarding sufficient apical (mid-compartment) support by the MP and concerns about the risk of dyspareunia. The aims of this study were therefore to investigate anatomical and patient-reported outcomes 1 year after MP. METHODS: Prospective cohort study of 153 females undergoing an MP for anterior compartment POP between October 2014 and June 2016. Pre- and 1-year postoperative evaluations included POP-Q measurements and the questionnaires Pelvic Floor Distress Inventory Short Form 20 (PFDI-20) and POP/Urinary Incontinence Sexual Questionnaire (PISQ-12). RESULTS: At 1 year, 97% (148/153) attended the follow-up. Significant anatomical improvements (p < 0.01) were obtained in all compartments. Mean Ba was -1.1 (± 1.4), mean C -5.9 (± 1.7) and mean D -7.0 (± 1.2) at follow-up. Point C ≤ -5 was present in 81.1%. POP-Q stage 0-1 was obtained in 99.3% in the mid-compartment (C < -1), but only in 48.6% in the anterior compartment (Ba < -1). A significant reduction in symptom scores was obtained for PFDI-20 (p < 0.01) and PISQ-12 (p = 0.01). No significant changes were seen in dyspareunia rates (q.5, PISQ-12), but 5.6% reported de novo dyspareunia. Concerning POP symptoms, 96.0% reported being cured or significantly improved. CONCLUSIONS: The Manchester procedure provides adequate apical support, albeit inferior anatomical anterior compartment results, and 96.0% reported being subjectively cured or substantially better at 1-year follow-up, with no significant change in dyspareunia.
INTRODUCTION AND HYPOTHESIS: Classical native-tissue techniques for pelvic organ prolapse (POP) repairs, such as the Manchester procedure (MP), have been revitalized because of vaginal mesh complications. However, there are conflicting opinions regarding sufficient apical (mid-compartment) support by the MP and concerns about the risk of dyspareunia. The aims of this study were therefore to investigate anatomical and patient-reported outcomes 1 year after MP. METHODS: Prospective cohort study of 153 females undergoing an MP for anterior compartment POP between October 2014 and June 2016. Pre- and 1-year postoperative evaluations included POP-Q measurements and the questionnaires Pelvic Floor Distress Inventory Short Form 20 (PFDI-20) and POP/Urinary Incontinence Sexual Questionnaire (PISQ-12). RESULTS: At 1 year, 97% (148/153) attended the follow-up. Significant anatomical improvements (p < 0.01) were obtained in all compartments. Mean Ba was -1.1 (± 1.4), mean C -5.9 (± 1.7) and mean D -7.0 (± 1.2) at follow-up. Point C ≤ -5 was present in 81.1%. POP-Q stage 0-1 was obtained in 99.3% in the mid-compartment (C < -1), but only in 48.6% in the anterior compartment (Ba < -1). A significant reduction in symptom scores was obtained for PFDI-20 (p < 0.01) and PISQ-12 (p = 0.01). No significant changes were seen in dyspareunia rates (q.5, PISQ-12), but 5.6% reported de novo dyspareunia. Concerning POP symptoms, 96.0% reported being cured or significantly improved. CONCLUSIONS: The Manchester procedure provides adequate apical support, albeit inferior anatomical anterior compartment results, and 96.0% reported being subjectively cured or substantially better at 1-year follow-up, with no significant change in dyspareunia.
Entities:
Keywords:
Dyspareunia; Gynecologic surgical procedures; Pelvic organ prolapse; Recurrence
Authors: Bernard T Haylen; Christopher F Maher; Matthew D Barber; Sérgio Camargo; Vani Dandolu; Alex Digesu; Howard B Goldman; Martin Huser; Alfredo L Milani; Paul A Moran; Gabriel N Schaer; Mariëlla I J Withagen Journal: Neurourol Urodyn Date: 2016-01-07 Impact factor: 2.696
Authors: Jason D Wright; Thomas J Herzog; Jennifer Tsui; Cande V Ananth; Sharyn N Lewin; Yu-Shiang Lu; Alfred I Neugut; Dawn L Hershman Journal: Obstet Gynecol Date: 2013-08 Impact factor: 7.661
Authors: Marie-Andrée Harvey; Hui Ju Chih; Roxana Geoffrion; Baharak Amir; Alka Bhide; Pawel Miotla; Peter F W M Rosier; Ifeoma Offiah; Manidip Pal; Alexandriah Nicole Alas Journal: Int Urogynecol J Date: 2021-08-02 Impact factor: 2.894
Authors: Sascha F M Schulten; Rosa A Enklaar; Kirsten B Kluivers; Sanne A L van Leijsen; Marijke C Jansen-van der Weide; Eddy M M Adang; Jeroen van Bavel; Heleen van Dongen; Maaike B E Gerritse; Iris van Gestel; G G Alec Malmberg; Ronald J C Mouw; Deliana A van Rumpt-van de Geest; Wilbert A Spaans; Annemarie van der Steen; Jelle Stekelenburg; E Stella M Tiersma; Anneke C Verkleij-Hagoort; Astrid Vollebregt; Chantal B M Wingen; Mirjam Weemhoff; Hugo W F van Eijndhoven Journal: BMC Womens Health Date: 2019-04-02 Impact factor: 2.809
Authors: Rosa A Enklaar; Brigitte A B Essers; Leanne Ter Horst; Kirsten B Kluivers; Mirjam Weemhoff Journal: Int Urogynecol J Date: 2020-10-26 Impact factor: 2.894