1. Pelvic Organ Prolapse Definition and Classification
*A prolapse is a downward or forward displacement of one of the pelvic organs from its normal location.
*A variety of terms are used to describe female genital prolapse.
*A cystocele is a downward displacement of the bladder.
*A cystourethrocele is a cystocele that imcludes the urethra as part of the prolapsing organ complex.

2. Symptoms of Prolapse *feeling of pressure
*A uterine prolapse is a descent of the uterus and cervix down the vaginal canal toward the vaginal introitus.
*rectocele
*enterocele
Symptoms of Prolapse
*feeling of pressure
*something is protruding from the vagina
*stress urinary incontinence
*voiding difficulty
*inefficient rectal emptying

3. Stage of Pelvic Organ Prolapse
Stage No prolapse is demonstrated
Stage >1cm above the level of the hymen
Stage 2 the plane of the hymen
Stage 3 >1cm below the plane of the hymen
Stage 4 nearly complete eversion of the vagina

4. Examination Treatment
*all aspects of vaginal support should be carefully surveyed.
*examining patients in the standing position as well as in the standard dorsal lithotomy position.
Treatment
*Asymptomatic prolapse
*to undergo surgical bladder neck suspension

5. *Vaginal Hysterectomy
Surgery
*Vaginal Hysterectomy
*Manchester Operation
*Uteropexy
*Paravaginal Defect Repair Operation
*Posterior Colporrhaphy
*Colpectomy and Colpocleisis
*Colpopexy