Uterus preserving surgery

Manchester repair is a specialized surgical procedure used to treat uterine prolapse while preserving the uterus. It is an important option for women who wish to retain their uterus for personal, reproductive, or psychological reasons while still addressing symptoms of pelvic organ prolapse.

Dr. Amit Majumdar, Consultant Obstetrician and Gynaecologist with super-specialty expertise in urogynaecology, offers Manchester repair as part of advanced pelvic floor surgical care. His approach focuses on restoring normal anatomy, improving function, and maintaining long-term pelvic support.

What is Uterine Prolapse?

Uterine prolapse occurs when the uterus descends from its normal position into the vaginal canal due to weakening of pelvic floor muscles and ligaments.

Common causes include:

• Vaginal childbirth
• Aging and reduced tissue strength
• Hormonal changes
• Chronic straining or heavy lifting

Symptoms of Uterine Prolapse

Women with prolapse may experience:

• A sensation of heaviness or pressure in the pelvis
• Feeling of something “coming down” in the vagina
• Discomfort during walking or standing
• Difficulty with urination or bowel movements
• Lower back discomfort

These symptoms can gradually worsen if left untreated.

What is Manchester Repair?

Manchester repair is a uterus-preserving surgical technique designed to reposition and support the uterus without removing it.

The procedure involves:

• Shortening and strengthening the supporting ligaments
• Repairing the vaginal walls if required
• Restoring the uterus to its normal position

It is particularly suitable for women with uterine prolapse who prefer to avoid hysterectomy.

Who is the Ideal Candidate?

Manchester repair is suitable for:

• Women with uterine prolapse who wish to preserve the uterus
• Younger patients or those considering future fertility
• Patients without significant uterine disease requiring removal
• Women seeking a conservative surgical approach

Dr. Amit carefully evaluates each case to ensure the procedure is appropriate and beneficial.

Types / Variations of the Procedure

Depending on the patient’s condition, Manchester repair may be combined with other procedures:

1. Manchester Repair with Cervical Reduction

In cases where the cervix is elongated, it may be shortened as part of the procedure.

2. Manchester Repair with Pelvic Floor Repair

If there is associated bladder or rectal prolapse, anterior or posterior repair may be performed at the same time.

3. Manchester Repair with Additional Support Procedures

In selected cases, additional techniques may be used to enhance long-term pelvic support.

What Happens During the Procedure?

Step-by-step overview:

1. Pre-operative assessment

• Detailed consultation and pelvic examination
• Evaluation of prolapse severity
• Necessary investigations

2. Anesthesia

• Performed under regional or general anesthesia

3. Surgical procedure

• The cervix may be shortened if elongated
• Supporting ligaments are repositioned and tightened
• Vaginal walls are repaired if needed
• The uterus is lifted and secured in its normal position

4. Completion

• Sutures are placed
• Patient is monitored during recovery

The procedure is performed through the vaginal route, avoiding external incisions.

What Should Patients Expect?

Before Surgery

• Detailed explanation of procedure and alternatives
• Pre-operative preparation guidance
• Discussion of expectations and outcomes

During Surgery

• Minimally invasive vaginal approach
• No external scars
• Focus on preserving uterus and function

After Surgery

• Short hospital stay
• Mild to moderate discomfort initially
• Gradual improvement in symptoms

Recovery & Aftercare

Recovery typically includes:

• Avoiding heavy lifting for several weeks
• Maintaining good bowel habits
• Following hygiene and care instructions
• Attending follow-up visits

Pelvic floor strengthening may be recommended after recovery to maintain long-term results.

Benefits of Manchester Repair

• Preservation of the uterus
• Relief from prolapse symptoms
• Restoration of pelvic support
• Minimally invasive approach
• Improved quality of life

Why Choose Dr. Amit Majumdar?

Patients choose Dr. Amit for:

✔ Super-specialty expertise in urogynaecology

✔ Experience in uterus-preserving surgical techniques

✔ Personalized treatment planning

✔ Focus on minimally invasive approaches

✔ Compassionate and patient-centered care

His goal is to provide effective treatment while respecting each patient’s preferences and long-term wellbeing.

When to Seek Medical Advice

You should consider consultation if you experience:

• Vaginal bulging or pressure
• Symptoms of uterine prolapse
• Discomfort affecting daily life
• Progressive worsening of symptoms

Early evaluation allows for more treatment options and better outcomes.

Book Your Consultation

If you are experiencing symptoms of uterine prolapse and wish to explore uterus-preserving options, expert advice can help you make the right decision.

Schedule your consultation with Dr. Amit Majumdar to discuss personalized treatment options and regain comfort with confidence.