Tiwari, Kenusha DeviShrestha, RanjanaDangal, GaneshPradhan, HemaBhattachan, KabinShah, Sadhana2026-07-092026-07-092025https://hdl.handle.net/20.500.14572/6919Kenusha Devi Tiwari Department of Obstetrics and Gynaecology, Kathmandu Model Hospital Institute of Health Sciences, Kathmandu Ranjana Shrestha Department of Obstetrics and Gynaecology, Kathmandu Model Hospital Institute of Health Sciences, Kathmandu Ganesh Dangal Department of Obstetrics and Gynaecology, Kathmandu Model Hospital Institute of Health Sciences, Kathmandu Hema Pradhan Department of Obstetrics and Gynaecology, Kathmandu Model Hospital Institute of Health Sciences, Kathmandu Kabin Bhattachan Department of Obstetrics and Gynaecology, Kathmandu Model Hospital Institute of Health Sciences, Kathmandu Sadhana Shah Department of Obstetrics and Gynaecology, Kathmandu Model Hospital Institute of Health Sciences, KathmanduAbstract: Severe cervical elongation in young multiparous women is a rare cause of pelvic organ prolapse. Achieving durable apical support while preserving the uterus presents a surgical challenge. A 26-year-old unmarried nullipara with 12 years history of pelvic organ prolapse with cervical elongation of 9cm. She underwent Manchester procedure combined with Right sacrospinous ligament fixation of the neo cervix under anesthesia. This combined approach addressed the anatomical defect and provided robust apical suspension. This case demonstrated the feasibility and rationale for this combined approach in a medically complex patient.en-USCervical elongationManchester procedurePelvic organ prolapsesacrospinous fixationyoungBook