A 30 years old multipara has uterine prolapse the management of choice is :
Ans. is b i.e. Fothergill's repair with tuba! ligation Fothergill's operation(Manchester Repair) is done in women below 40 years, who want to retain their menstrual function . This lady fulfills all these criteria and so Fothergill's repair is the ideal management for her. Fothergill's repair causes complications of pregnancy like incompetent os, habitual aboion and Cervical dystocia. Therefore tubal ligation should be done to prevent these complications i.e. fothergills should be avoided in women who want more children. Components of Fothergill's operation / Manchester operation : Preliminary D & C (to facilitate creation of vaginal flaps and to rule out malignancy) Amputation of cervix Plication of Mackenrodt's ligament in front of the cervix Anterior colporrhaphy Colpoperineorrhaphy. Complications 1. Cervical amputation leads to : - Incompetent os - Habitual aboion -- Premature rupture of membranes -- Decreased feility Excessive fibrosis causes stenosis leading to dystocia during labour. Hematometra Recurrence of prolapse.
Fothergill's repair
Fothergill's repair with tubal ligation
Sling operation
Vaginal hysterectomy