Question
A woman who is being investigated for infertility is diagnosed to have a multiparous prolapse of the uterus. The most appropriate management will be:
| A. |
Ring pessary
|
| B. |
Fothergill repair
|
| C. |
Sling operation
|
| D. |
Cervical amputation
|
Show Answer
|
Correct Answer » C
Explanation
|
|
- The patient has uterine prolapse and infertility.
- She desires preservation of fertility.
- Therefore, treatment must be uterine-conserving and restore anatomy for future pregnancy.
- Sling operation (e.g., Shirodkar sling) supports the uterus by suspending it.
- It preserves the uterus and maintains reproductive potential.
- It is the preferred surgical option in young women desiring fertility.
Explanation why other options are incorrect
Option A. Ring pessary
- Conservative, temporary measure
- Used in elderly or unfit for surgery
- Does not correct infertility cause
Option B. Fothergill repair (Manchester operation)
- Includes cervical amputation
- Can lead to cervical incompetence
- Not preferred in women desiring fertility
Option D. Cervical amputation
- Removes part of cervix
- Risks infertility and cervical incompetence
- Not appropriate in this scenario
