Purandare Procedure for Management of Grade IV Uterine Prolapse in Women of Reproductive Age: A Case Report

Uterine prolapse, a common pelvic organ prolapse (POP), results from weakened pelvic floor support, causing the uterus to descend into the vagina. It is rare in reproductive-aged women with low parity. The Purandare technique offers a uterus-preserving option, using rectus abdominis fascia for abdominal suspension. The aim of this case report is to present the management of pelvic organ prolapse in a reproductive-age woman, with an emphasis on uterine preservation. This case report describes a 37-year-old, P1A0, with grade IV uterine prolapse, cystocele, and rectocele, experiencing a vaginal mass for nine years and defecation difficulties, but no urinary symptoms. After counseling and consent, the Purandare procedure was performed under spinal anesthesia. Postoperative follow-up at two weeks evaluated anatomical correction, recovery, and patient satisfaction, monitoring complications and functional outcomes. Results showed significant improvement in pelvic organ function, urinary and digestive health, sexual function, and overall quality of life. These improvements supported her roles as a working woman, wife, and mother, enhancing her dignity and social participation. In conclusion, the Purandare technique is a viable, effective option for reproductive-age women with POP who wish to preserve fertility and their uterus, providing favorable anatomical and functional outcomes.