Citation :

Mala Raj, Priyadharshini Karunakaran, Medha Laxmikant Karadi, Dhivya Venkatesan, "An Uncommon Descent: Uterus-Preserving Laparoscopic Pectopexy for Stage III Uterine Prolapse in a Nulligravid Woman," International Journal of Medical Science, vol. 13, no. 3, pp. 1-6, 2026. Crossref, https://doi.org/10.14445/23939117/IJMS-V13I3P101

Abstract

Background: Pelvic Organ Prolapse (POP) in nulliparous women is rare and poses unique challenges in management, particularly in preserving fertility. Laparoscopic pectopexy has emerged as a safe alternative to sacrocolpopexy, avoiding presacral dissection and its associated complications. Case Presentation: A 23-year-old nulliparous woman presented with complaints of a progressively increasing mass descending per vaginum for one year, associated with discomfort during standing and walking. Clinical examination and POP-Q assessment revealed Stage III uterine prolapse (point C +3) with anterior compartment involvement. Extensive evaluation ruled out connective tissue disorders, systemic inflammation, metabolic causes, and mechanical strain factors. The patient underwent laparoscopic pectopexy, using a polypropylene mesh fixed bilaterally to the iliopectineal (pectineal/Cooper’s) ligaments with non-absorbable sutures. Results: The procedure was completed without intraoperative or postoperative complications. The patient showed excellent anatomical correction and complete resolution of symptoms. Conclusion: Laparoscopic pectopexy is a safe, effective, and fertility-preserving surgical option for managing apical prolapse in young nulliparous women.

Keywords

Pectopexy, Pelvic Organ Prolapse, Nulliparous, Laparoscopy, Cooper’s Ligament.

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