This prospective interventional randomized controlled trial is conducted to compare a new technique for Sacrospinous-Sacrotuberous fixation with the traditional sacrospinous ligament fixation technique for treatment of uterovaginal and vaginal vault prolapse.

Inclusion Criteria:

1. Age from 40 to 60 years.
2. POP Q stage III & IV
3. Uterovaginal prolapse.
4. Vaginal vault prolapse.
5. BMI >35.

Exclusion Criteria:

1. Age > 40 years or < 60 years.
2. POP Q stage I or II.
3. BMI < 35.
4. Previous repair of uterovaginal or vaginal vault prolapse.
5. Comorbidity with Stress Urinary Incontinence.
6. Presence of persistent risk factor increasing intra-abdominal pressure e.g. chronic chest conditions.
7. Any significant comorbidity or psychiatric disorder that would compromise patient's consent.