摘要
Poor cure rates for prolapse repair reported by the PROSPECT TRIAL1 and total mesh bans after the Cumberlage Report,2 leave few options for vaginal surgery for urogynecologists worldwide.One remaining option,the Fothergill-Manchester Repair began as a modification of the Donald operation.3 Fothergill emphasized the role of cardinal ligament(CL)and uterosacral(USL)ligaments in uterine prolapse repair.4 The classical Manchester operation involves full thickness inverted V-shaped vaginal excisions(Fig.1).The cervix is dilated and if elongated,it is amputated.CLs are severed and sutured to the anterior part of cervix.USLs may also be severed.Sturmdorf sutures bring vaginal flaps into the cervical canal.Vagina is repaired.The operation can be traumatic,some even reported a large quantity blood loss as high as 850 ml,5 possibly related to severing of CLs which contains uterine artery branches and also,failure of Sturmdorf sutures to control bleeding from cervical amputation.
基金
Thanks for Dmitry Shkarupa for Table 1.This work was supported by the National Key R&D Program of China(2018YFC2002202)
Special Found of China Plastic Association(2020-Z-33).
