Development of Cervical and Uterine Malignancies During Follow-Up After Manchester-Fothergill Procedure

Objective: This study was conducted to assess the risk of cervical or uterine malignancy development following pelvic organ prolapse (POP) surgery using the Manchester-Fothergill procedure, with the aim of elucidating the potential risks of uterine-conserving surgical treatment of POP. Materials and Methods: This study included Manchester-Fothergill procedures performed at Aalborg University Hospital, in Aalborg, Denmark, from 1996 to 2016. Information was retrieved regarding patient parity, body mass index, and smoking status, as well as data from postsurgical Papanicolaou smears, endometrial biopsies, and cervical and endometrial histopathologic analyses. Data were collected from the electronic medical records and the Danish Urogynecological database Results: A total of 299 Manchester-Fothergill procedures were included, with a mean follow-up time of 7.8 years (range: 0-21.4 years). After surgery, histopathologic analyses revealed abnormal cervical or uterine developments in 6 patients: simple benign endometrial hyperplasia without atypia in 5 patients, and cervical intraepithelial neoplasia, which turned normal 6 months later in 1 patient. Conclusions: There appears to be a low risk of developing cervical or uterine malignancy after the Manchester-Fothergill procedure. Additional studies are needed to examine the risks and benefits of uterus-sparing procedures further.