Hysteropexy inferior to Manchester Procedure for Uterine Descent: JAMA

The findings published in the Journal of American Medical Association found that sacrospinous hysteropexy demonstrates inferiority compared to the Manchester procedure.

Pelvic organ prolapse, a condition in which the uterus or other organs descend into the vaginal canal, often necessitates surgical intervention. Sacrospinous hysteropexy, the prevailing uterus-preserving approach, has dominated the field. However, the older Manchester procedure still holds ground as an alternative technique. So, Enklaar Rosa and team conducted this randomized clinical trial across 26 hospitals in the Netherlands on the comparative effectiveness of two popular surgical techniques: sacrospinous hysteropexy and the Manchester procedure.

This landmark study, which involved 434 adult patients undergoing their first surgical treatment for uterine descent that did not protrude beyond the hymen, sought to address this information gap. Participants were randomly assigned to undergo either sacrospinous hysteropexy or the Manchester procedure. The primary measure of success was a composite outcome that included factors such as absence of pelvic organ prolapse beyond the hymen, absence of bothersome bulge symptoms, and no need for prolapse retreatment within two years post-operation.