Evaluation of two vaginal, uterussparing surgical methods for pelvic organ prolapse reconstruction: modified Manchester operation (MM) and sacrospinal hysteropexy (SSH).

This study will be a comparison of the two uterus sparing techniques (effectiveness and costs). We hypothesize that the overall effectiveness of SSH is non-inferior to MM, but with shorter operation times. The study may lead to more knowledge on the subgroups that benefit from either procedure or may show the need for deimplementation of one of the procedures. The study will reveal whether the existing practice pattern variation is unwanted or not significant in terms of effectiveness and cost.

non-inferiority

Primary composite outcome after 6 weeks, 1 year and 2 years

- SSH in which the uterus is attached to a fibrotic band in the pelvis (rightside sacrospinous ligament).

- MM operation in which the cervix is partially removed and the uterus is supported by plication of its own fibrotic support tissues (uterosacral ligaments).