Acceso usuarios
Paula de Holanda Mendes, Caroline Rigolon Veiga, Gutemberg Almeida
This study aims to evaluate the effectiveness of the Manchester operation (MO) in patients with a partially prolapsed uterus, with or without uterine cervix hypertrophy at all ages, expanding its indications. This is a retrospective cohort study evaluated 69 consecutive patients with partial uterine prolapse, who underwent the MO, between march 2015 and december 2020. Sixty-two patients aged 36 to 84 years were included. Forty-one patients had uterine prolapse associated with cervical hypertrophy (UPH) and 21 patients had uterine prolapse without hypertrophy (UP-NOH). All patients were evaluated 12 months after the operation regarding subjective and objective prolapse cure rates by group and by age. The global subjective and objective cure rate was 95%, being 92.7% in the UPH group, and 100% in the UP-NOH group (p>.05). The average age among women undergoing surgery with symptom recurrence was 41.6 years, while asymptomatic women were 66.2 years (p<.05). Apical anatomical recurrence occurred among patients with a mean age of 52 years, whereas women without recurrence were 65.7 years old (p< .05). The MO can be considered an effective alternative for the correction of partial uterine prolapse with or without cervical hypertrophy, regardless of the woman's age, with high subjective and objective cure rates. Older women have a lower risk of recurrence of symptoms and recurrence of apical prolapse after 12 months. Uterine preservation in women with prolapse should be considered at any age, without harm to health. Respect for women's wishes is highlighted, contributing to the fight against ageism in surgical decisions.
