Open sacrohysteropexy with polypropylene mesh for stage III uterovaginal prolapse in a young premenopausal woman with concurrent recurrent pregnancy loss: a case report

Abstract

Uterovaginal prolapse (UVP) occurring in premenopausal women demands uterus-preserving surgical strategies that offer durable anatomical correction without compromising future reproductive potential. Open sacrohysteropexy (OSH) using type-I polypropylene mesh achieves reliable apical support while retaining the uterus. When accompanied by recurrent pregnancy loss (RPL), the clinical picture warrants a concurrent systematic aetiological evaluation.A 39-year-old woman (P1L1A3) presented with a five-to-six-year history of a vaginal mass prolapsing through the introitus, lower abdominal discomfort, and dysuria. Examination demonstrated the cervix lying 2 cm beyond the hymenal ring, consistent with Pelvic Organ Prolapse Quantification (POP-Q) Stage III uterocervical descent, a Stage I anterior compartment defect (cystocele), and the absence of posterior compartment prolapse on reduction. She additionally carried an evolving diagnosis of RPL following three consecutive first-trimester pregnancy losses. Open sacrohysteropexy with polypropylene mesh was performed under general anaesthesia on 19 February 2026 and was completed without intraoperative complications. The postoperative course was uneventful, and the patient was discharged in stable condition on postoperative day six.Open sacrohysteropexy with polypropylene mesh is a safe and reproducible uterus-preserving procedure for advanced pelvic organ prolapse in young women. Its concurrent use with structured RPL investigation represents an opportunity to address both anatomical and reproductive morbidity within the same admission episode.