Karen Ruben Husby

Around 20% of all Danish women will at some stage in life have surgery for pelvic organ prolapse, a condition where the womb, bladder or rectum slip down into the vagina.

‘One in five women experience prolapse – and the biggest risk factor is giving birth vaginally,’ says medical doctor and PhD student Karen Ruben Husby.

Ruben Husby is one of five young scientists receiving a Lundbeck Foundation 2022 Talent Prize.

She has been researching pelvic organ prolapse treatment since 2016. Her specific field of interest is uterine prolapse, where the womb slips down into the vagina.

As a medical student, she had the opportunity to join a research project at the Department of Gynaecology and Obstetrics at Herlev-Gentofte Hospital, with which she is still affiliated.

The research project concerned the so-called Manchester procedure, which Herlev-Gentofte Hospital had long been using to treat women with uterine prolapse.

This procedure, originally introduced back in 1888 by the British physician Archibald Donald, who practised in Manchester, involves shortening the lower section of the cervix (neck of the womb) and then suturing the womb back into place. In this way, the Manchester procedure is radically different from vaginal hysterectomy, which is also used to treat urine prolapse, since vaginal hysterectomy removes the womb altogether.

‘When I started my research on uterine prolapse, an international guideline had recently relegated the Manchester procedure from modern gynaecology due to lack of knowledge of the procedure,’ explains Ruben Husby, who is also affiliated with the Department of Clinical Medicine at the University of Copenhagen.

Herlev-Gentofte Hospital, however, disagreed with this conclusion in the international guideline. On the contrary, doctors at the Department of Gynaecology and Obstetrics asserted that the Manchester procedure was the first-line surgical procedure for uterine prolapse. The Department’s research team consequently decided to subject the Manchester procedure to a rigorous scientific test, and this was the research project in which Ruben Husby came to play a lead role.

The research team designed a number of scientific projects to map the Manchester procedure, and the results of these projects have in recent years been presented at a number of international conferences where Ruben Husby has been awarded several prizes.

‘I recently presented some of our studies at a Nordic gynaecology conference, and this was the first time I experienced general consensus that the Manchester procedure  – almost as a matter of course – should be the first-line option for women requiring surgical intervention for uterine prolapse,’ explains Ruben Husby, adding:

‘This is confirmed both by the series of studies we have conducted and by similar Swedish and Norwegian studies, which have subsequently validated our findings. Our research outcomes have also meant that the Manchester procedure has gone global, and prominent international gynaecologists are now asking if they can visit us to learn the technique’.

Pelvic organ prolapse can impair women’s quality of life in several respects, and may, for example, severely limit womens’ social life, physical activity, and cause major problems for their sex life.

‘The preliminary conclusion is clear: The Manchester procedure is the least traumatic and lowest-cost surgery, and the one that results in the lowest rate of relapse and complications in the treatment of uterine prolapse. In Scandinavia, this is now the first-line procedure for treating uterine prolapse, and the rest of the world appears to be following our lead,’ says Ruben Husby.

Karen talks about her research and the prize: 

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