The Manchester-Fothergill Procedure as a Fertility Sparing Alternative for Pelvic Organ Prolapse in Young Women

Abstract 

Although reproductive organ prolapse typically affects older, parous women, a certain population of children and adolescents, primarily adolescents with congenital spinal defects, are also at risk. The Manchester-Fothergill procedure was first performed in 1888 by Dr. Archibald Donald of Manchester, England. 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. It is crucial to educate younger physicians about the technical aspects of this procedure so as not to lose this operation as an alternative surgical approach. We present a case of recurrent uterine prolapse after a prior laparoscopic uterine suspension procedure. In order to address recurrent prolapse, which was accompanied by cervical elongation, this young woman elected to have additional surgical management with the Manchester-Fothergill procedure. We describe the procedure in detail, accompanied by photographs taken during the operation to fully illustrate the extent of this patient's condition and to document the surgical technique. The Manchester Fothergill procedure is an additional fertility-sparing surgical approach to treatment of pelvic organ prolapse.

Key Words: Manchester-Fothergill procedure, Prolapse, Myelomeningocele