Clinical case of surgical management of recurrent pelvic organ prolapse in a woman of reproductive age using a combined approach with cell-based technologies

Introduction. Pelvic organ prolapse remains one of the most significant challenges in modern gynecology, profoundly affecting patients’ quality of life. Selecting a surgical strategy for young women is particularly complex due to their reproductive plans and the limitations on using synthetic meshes because of the risk of mesh-associated complications. Meanwhile, native tissue repair, while remaining the basic surgical approach, is associated with a significant risk of recurrence, especially in patients with underlying connective tissue incompetence. In this context, the search for biologically oriented, organ-preserving surgical techniques is highly relevant, aiming not only at mechanical correction but also at restoring the quality of the patient’s own pelvic floor tissues.

Objective. To present a clinical case of surgical treatment for recurrent stage III pelvic organ prolapse (POP-Q classification) in a woman of reproductive age, using native tissue repair combined with subfascial injection of micro-fragmented adipose tissue.

Materials and Methods. We performed treatment and clinical follow-up on a woman of reproductive age diagnosed with recurrent stage III pelvic organ prolapse (POP-Q classification), primarily involving the anterior compartment. The patient underwent organ-preserving surgery involving native tissue repair of the anterior vaginal wall combined with subfascial injection of micro-fragmented adipose tissue.

Results. Follow-up examinations at 1, 3, 6, and 12 months demonstrated restoration of normal pelvic anatomy: the position of the anterior vaginal wall corresponded to stage 0 prolapse according to the POP-Q system. No clinical or instrumental signs of cystocele recurrence were detected. The patient reported a significant improvement in quality of life, resolution of the sensation of vaginal bulging, absence of voiding symptoms, and restoration of sexual function.

Conclusion. The combined treatment method for recurrent pelvic organ prolapse — native tissue repair with subfascial injection of micro-fragmented adipose tissue — demonstrated clinical effcacy and safety in this reproductive-age patient. The approach restored anatomical support of the anterior compartment with no signs of recurrence during the 12-month follow-up, alleviated symptoms, and improved quality of life.

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