Sacrospinous Hysteropexy Inferior to Manchester Procedure for Uterine Descent

WEDNESDAY, Aug. 23, 2023 (HealthDay News) -- For patients with uterine descent, sacrospinous hysteropexy is inferior to the Manchester procedure for first surgical treatment, according to a study published in the Aug. 15 issue of the Journal of the American Medical Association.

Rosa A. Enklaar, M.D., from Radboud University Medical Center in Nijmegen, the Netherlands, and colleagues compared the success of sacrospinous hysteropexy to the Manchester procedure for surgical treatment of uterine descent in a noninferiority randomized clinical trial involving 434 adults undergoing a first surgical treatment for uterine descent that did not protrude beyond the hymen.

The as-randomized analysis included 393 participants: 196 in the sacrospinous hysteropexy group and 197 in the Manchester procedure group. The researchers found that 77.0 and 87.3 percent of participants in the sacrospinous hysteropexy and Manchester procedure groups, respectively, achieved the composite outcome of success. However, the noninferiority criterion of −9 percent for the lower limit of the confidence interval was not met by sacrospinous hysteropexy (risk difference, −10.3 percent; 95 percent confidence interval, −17.8 to −2.8 percent; P = 0.63 for noninferiority). Perioperative outcomes and patient-reported outcomes did not differ between the groups at two-year follow-up.

"Patients who underwent the Manchester procedure had a better composite outcome of success after two-year follow-up, consistent with inferiority of sacrospinous hysteropexy," the authors write.

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