The anterior colporrhaphy with the attachment of mackenrodt ligament to the cervix, without cervical amputation, is shirodhkar’s procedure. It is a modification of the fothergill operation (Manchester operation). It is for the women below the age of the 40 who have completed their family but want to retain their menstrual function.
Shirodkar procedure :- The anterior colporrhaphy followed by the attachment of mackenrodt ligament to the cervix on each side. The vaginal incision is then extended posteriorly around the cervix. The uterosacral ligaments are divided close to the service and are crossed and stitched together in front of the cervix. This is followed by a high closure of the peritoneum of the pouch of Douglas.
The operation preserves menstrual and child bearing functions. The cervix is not amputated which avoids subsequent pregnancy complications. The rest of the operation is similar to the fothergill’s operation.
Options A&D :- Fothergill operation is also known as the Manchester operation, refer to an anterior colporrhaphy with the amputation of the cervix. The cut ends of the Mackenrodt ligament are situated in front of the cervix and the raw area of the amputated cervix is covered with the vaginal mucosa. It is followed by colpoperineorrhaphy. It preserves the menstrual and childbearing function