<p>Addressing advanced-stage (3–4) uterine prolapse with an cervical hypertrophy in young women desiring uterine preservation poses significant hurdles. The current vaginal-assisted laparoscopic sacrohysteropexy (VALSH) approach poses a heightened risk of infection and related problems due to mesh contact with the vagina. This study presents a revised VALSH approach designed to decrease mesh-vaginal contact in order to mitigate these hazards. This revised treatment was conducted on a 38-year-old female exhibiting symptomatic complete uterine prolapse (POP-Q stage IV) and an cervical hypertrophy. The principal distinction was the positioning of the Y-shaped polypropylene mesh via the intra-abdominal route instead of vaginally, thus minimising its interaction with vaginal tissue. The procedure lasted 120&#xa0;min, resulting in minimum blood loss, and no intraoperative problems were seen. The patient was discharged on the second surgical day and indicated full resolution of prolapse symptoms. Throughout the 18-month follow-up, there were no problems associated with the mesh, nor were there any urinary complaints, dyspareunia, or pelvic pain, and no further surgical intervention was necessary. In conclusion, based on this preliminary observation, the modified VALSH technique—designed to reduce contact between the vagina and the mesh—may serve as a potential alternative for women with advanced uterine prolapse desiring uterine preservation. However, definitive conclusions cannot be drawn from a single case, and future comparative studies are required to validate its clinical efficacy and safety.</p>