The Manchester-Fothergill technique: Browsing in the cutting-edge art gallery

Int J Gynaecol Obstet. 2022 Jan;156(1):10-16. doi: 10.1002/ijgo.13706. Epub 2021 Apr 28.

Abstract

Background: No consensus regarding the surgical strategy for repairs of pelvic organ prolapse (POP) has existed since the writings of Hippocrates. Archibald Donald of Manchester, in 1888, quite independently began to treat cases of prolapsus uteri with a combined operation of anterior and posterior colporrhaphy and amputation of the cervix.

Objective: To describe the surgical technique of Manchester-Fothergill and to chart its history.

Search strategy: A bibliographic search was performed of the PubMed and National Library of Medicine (NIH) databases.

Selection criteria: The terms "Manchester-Fothergill" AND "History" AND "Pelvic Organ Prolapse" were searched from the first publication on this topic (1951) to December 2020.

Data collection and analysis: Data were extracted from studies independently by two authors. All types of relevant abstracts were selected and analyzed due to the scarcity of studies (books and documents, clinical trials, meta-analysis, randomized controlled trial, review and systematic review).

Main results: Although this is a well-described procedure in historic texts, the practical application is not often employed, and modern surgical texts rarely describe how to perform this surgery. The advantages of the Manchester-Fothergill technique include maintenance of the pelvic anatomy, integrity, a reduction of intraoperative blood loss, and shortened operation times and hospital stays.

Conclusion: Many young gynecologists are not familiar with this operation; therefore, it is important to provide training and exposure to the Manchester-Fothergill technique in the practice of gynecological surgery.

Keywords: pelvic organ prolapse; reconstructive surgery; surgery.

Publication types

  • Review

MeSH terms

  • Cervix Uteri / surgery
  • Female
  • Gynecologic Surgical Procedures
  • Humans
  • Pelvic Organ Prolapse* / surgery
  • Plastic Surgery Procedures*
  • Uterus