Pelvic organ prolapse (POP) is defined by ICS as the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus, or the apex of the vagina (vaginal vault after hysterectomy) (1). In India, nulliparous prolapse constitutes 1.5 to 2% of prolapse (2). In young patients and nulliparous prolapse various conservative surgeries can be performed which include various sling surgeries, hysteropexies and Manchester-Fothergill surgery.
Here we present a video of modification of Purandare’s cervicopexy.

A low transverse abdominal incision given 2 cm above the pubic symphysis and abdomen opened in layers till rectus sheath reached. 2 slings of rectus sheath created 6x2 cm on each side of midline. Uterus held with Shirodkar’s uterine holding clamp and stay sutures taken from the medial ends of rectus strips with No. 1 Prolene. Rectus sheath strip brought into the peritoneal cavity lateral to rectus muscle and brought to the posterior surface of uterus through an avascular area in broad ligament. Tunnel created under the visceral peritoneum on posterior surface of uterus and rectus sheath strips passed under the visceral peritoneum of posterior surface of uterus on both the sides from lateral to medial and brought out in midline. Prolene sutures anchored at the ends of rectus sheath strips tied to each other in midline on posterior surface of uterus. The visceral peritoneum closed over the knot of prolene sutures to bury the knot with 1-0 Vicryl.

The operating time was 30 mina. There were no intraoperative or postoperative complications. Patient was discharged on post op day 2. At 12 months follow up, patient was asymptomatic and on examination there was no prolapse.

This modification for treatment of genital prolapse is an effective technique with no significant complications. Also mesh cost and mesh related complications are avoided.

Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, et al. An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecology J. 2016 Feb;27(2):165–94.
Virkud A. Conservative Operations in Genital Prolapse. J Obstet Gynaecol India. 2016 Jun;66(3):144–8.

Continence 15S (2025) 102225
DOI: 10.1016/j.cont.2025.102225