From the Research
Classical repair in uterine prolapse is a surgical approach that involves an anterior colporrhaphy, a posterior colporrhaphy, and often a perineorrhaphy to restore the normal anatomical position of the uterus and vagina, and is most suitable for women who have completed childbearing. This procedure typically involves the surgeon accessing the pelvic floor through vaginal incisions and using sutures to plicate (fold and tighten) the weakened fascial tissues.
- The surgery takes approximately 1-2 hours under spinal or general anesthesia, with a hospital stay of 1-3 days.
- Recovery typically requires 4-6 weeks of restricted activity, with no heavy lifting (over 10 pounds) or sexual intercourse during this period.
- Patients should expect some vaginal discharge and mild discomfort managed with oral pain medications like acetaminophen or NSAIDs. The choice of surgical approach depends on various factors, including the patient's age, comorbidities, activity level, desire for future fertility, and history of prior prolapse surgery, as well as the skill and comfort level of the surgeon with the particular surgery 1. A study published in 2017 compared the Manchester procedure with vaginal hysterectomy in the treatment of uterine prolapse and found that the Manchester procedure had lower recurrence rates and fewer complications 2. Another study published in 2021 reviewed the role of laparoscopic surgery in the treatment of advanced uterine prolapse and found that laparoscopic procedures had high anatomical cure rates and low complication rates 3. However, a study published in 2019 compared the efficiency of vaginal native tissue operations to treat primary apical prolapse and found that sacrospinous hysteropexy had higher reoperation rates due to prolapse recurrence compared to the Manchester-Fothergill procedure and vaginal hysterectomy 4. Overall, the choice of surgical approach for classical repair in uterine prolapse should be individualized based on the patient's specific needs and circumstances, and should prioritize minimizing morbidity, mortality, and improving quality of life.