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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제60권 제11호
발행연도
2019.1
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1,074 - 1,080 (7page)

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Purpose: Descent of the uterus is a major etiology of uterine prolapse. However, true cervical elongation can cause uterine prolapsewithout uterine descent. The aim of study was to investigate the clinical outcomes of Manchester operation in patients withuterine prolapse caused by “true cervical elongation,” compared with vaginal hysterectomy (VH). Materials and Methods: Medical records of patients who underwent Manchester operation or VH from 2006 to 2015 were reviewed. True cervical elongation was defined on the basis of C point of the Pelvic Organ Prolapse Quantification (POP-Q) system≥0 and D point ≤-4, as well as estimated cervical length of ≥5 cm. The primary outcome was recurrence of pelvic organ prolapse(POP) evaluated by POP-Q system. The outcomes of two groups were compared after propensity score matching, for age, parity,and preoperative POP-Q stage. Results: During the study period, 23 patients underwent Manchester operation and 374 patients underwent VH. The recurrencerate of POP (p=0.317) and complication rate were not statistically significant different between the two study groups. Manchesteroperation exhibited shorter operation time than VH (p=0.033). In subgroup analysis (POP-Q stage III), body mass index [odds ratio(OR)=1.74; 95% confidence interval (CI), 1.08–2.81] and not having concurrent anterior colporrhaphy (OR for concurrent anteriorcolporrhaphy, 0.06; 95% CI, 0.01–0.75) were identified as significant risk factors for recurrence of POP. Conclusion: The Manchester operation technique seems to be an effective and safe alternative procedure for the treatment ofuterine prolapse caused by true cervical elongation, compared with VH.

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