All of the following sling operations are done for uterine prolapse except:
Correct Answer: Manchester
Description: Ans: (d) ManchesterRef: Berek and Novak's Gynecology, 14th edition, Page 994Sling surgeries provide a substitute for the weakened supports of the uterus by using nylon or Dacron tapes as slings to support the uterus.Indications: 2nd or 3rd degree uterine prolapse in women who are desirous of retaining their child bearing and menstrual functions.The various sling operations are:A. Purandare's slingThe tape is fixed anteriorly to the uterine isthmus and lateral edges brought between leaves of broad ligament and fixed to the rectus sheath on either sidePlication of round ligamentMoschowitz's repair - abdominal correction of enteroceleB. Shirodkar's sling operationMesilene tape (originally fascia lata) is fixed to posterior aspect of the cervix and to the anterior longitudinal ligament of the sacral promontory.Sling taken through the Psoas loop on the left side due to the presence of sigmoid colonC. Khanna's sling operationMerseline tape fixed to the isthmus of cervix posteriorly and fixed to anterior superior iliac spine on either sides.Abdominocervicopexy MANCHESTER OPERATION IndicationsSuitable for women less than 40 years, completed their family with the intention of preserving menstrual functionII or III degree uterine prolapse with cystocele / rectocele with or without supravaginal elongation of cervix Principal StepsPreliminary D & CAmputation of cervixShortening of Mackenrodt's and anchoring in front of cervix.Anterior colporrhaphyPosterior colpoperineorrhaphyDisadvantages is mainly due to cervical amputation:Cervical incompetence leading to:Habitual abortionsPreterm deliveriesCervical stenosis leading toDystocia during laborHematometraHence usually preferred in women who have completed family
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Gynaecology & Obstetrics
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