With the improvement of people’s quality of life and the aging of the population, the incidence of pelvic organ prolapse (PO) is on the rise. The Women’s Health Study showed that the prevalence of uterine prolapse in married women ranged from 0.04 to 0.14%, 0.33% in women aged 51 to 60 years, and 0.71% in women aged 60 years and older. One study found that in the age segment of uterine prolapse, 12.5% were aged 50-59 years, and 76.7% were aged ≥60 years or older. Zhang Xiaowei, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China, said that pelvic organ prolapse (POP) refers to the detachment of pelvic organs from their normal anatomical position due to defective or loose supporting tissues of the pelvic floor. Uterine prolapse is defined as the uterus descending from its normal position along the vagina, with the external cervical opening reaching below the level of the sciatic spine, or even the uterus prolapsing completely outside the vaginal opening, often accompanied by prolapse of the anterior and posterior vaginal walls. Anterior vaginal wall prolapse can be isolated or combined with uterine prolapse and posterior vaginal wall prolapse. The pelvic floor structures supporting the pelvic organs are composed of multiple layers of muscles, fascia and ligaments.In 1992 Delancey proposed the theory of 3 levels of vaginal support structures, Level 1: the upper support structure – the main ligament-m sacral ligament complex; Level 2: the paravaginal support structure –Level 2: the paravaginal support structures – anal levator, vesicovaginal fascia and rectovaginal fascia; Level 3: the distal support structures – perineal body and sphincter. In addition, the “compartment theory” has been proposed recently, which divides the pelvic floor into three regions: anterior compartment, middle compartment, and posterior compartment. The anterior compartment includes the anterior vaginal wall, bladder, and urethra; the middle compartment includes the top of the vagina and uterus; and the posterior compartment includes the posterior vaginal wall and rectum. The prolapse is thus quantified to the individual chambers. The different chambers and different levels of prolapse are relatively independent of each other. For example, Level 1 defects in the vaginal support axis can lead to uterine prolapse and vaginal vault prolapse, whereas Level 2 and 3 defects often lead to prolapse of the anterior and/or posterior vaginal walls. Anterior pelvic defects can lead to bladder and anterior vaginal wall prolapse; middle pelvic defects can lead to uterine and vaginal vault prolapse; and posterior pelvic defects can lead to posterior vaginal wall and rectal bulge. [Pathogenesis] The pathogenesis of POP is unknown. (1) Due to the change of pelvic and abdominal dynamics in pregnancy, the combined force of the pelvic and abdominal cavity is changed, and the direction of the combined force is shifted from the normal direction of the sacrum to the direct action on the pelvic floor muscles. (2) Extremely dilated pelvic floor support structures in and around the soft birth canal during labor, elongated or torn muscle fibers, and reduced innervation of pelvic floor muscles, especially pelvic floor muscles and nerve injuries caused by assisted labor and delivery. (3) Premature participation in physical labor after delivery, especially heavy physical labor, will affect the recovery of pelvic floor tissue tension, resulting in different degrees of decline of the non-replaced uterus, often accompanied by prolapse of the anterior and posterior vaginal walls. 2. Loose and weak supporting tissues (1) Postmenopausal estrogen reduction, atrophy and degeneration of pelvic floor tissues are weak, and uterine prolapse easily occurs in elderly women. (2) Weakness of the tissue supporting the uterus caused by malnutrition. (3) Congenital dysplasia of the pelvic floor tissues. [POP predisposing factors] 1. Susceptibility factors: there are genetic susceptibility factors (congenital or hereditary); there are differences in the incidence of different races: white > African-American. 2, predisposing factors: pregnancy and childbirth, obesity, chronic cough, constipation, and occupational activities (frequent weight bearing) are the main predisposing factors for POP. Clinical manifestations and diagnosis] 1. Symptoms: Mild patients mostly have no conscious symptoms. (1) Protruding mass symptoms: pelvic pressure or swelling, lumbosacral pressure or pain, prolapsed mass in the vaginal orifice or outside the vagina, severe cases may have cervical or vaginal ulcers. (2) urinary tract symptoms: urethral dilatation, stress urinary incontinence, urinary urgency, urinary frequency, urge incontinence; bladder dilatation is serious, there can be difficult urination symptoms, including delayed urination, incomplete urination or need to return the uterus to empty the bladder; if accompanied by bladder forced urinary muscle dysfunction can have chronic urinary retention. (3) Abnormal defecation symptoms: In case of rectal distension or intestinal hernia, it may be accompanied by constipation symptoms or difficulty in defecation, and the need to reduce the degree of prolapse or increase abdominal pressure for defecation. (4) sexual intercourse difficulties: some patients may be accompanied by painful sexual intercourse, sexual intercourse difficulties. (2) Localization of pelvic floor defects, such as the presence of paravaginal defects or urethral subluxation in patients with anterior vaginal wall prolapse, vaginal vault prolapse or ventral hernia in uterine prolapse, and rectal bulge or intestinal hernia in posterior vaginal wall prolapse. (3) Special examinations related to stress urinary incontinence. (3) Auxiliary examinations: (1) Ultrasonography: perineal ultrasonography to understand suburethral migration and to assist in the localization and diagnosis of pelvic floor defects. Pelvic ultrasonography to exclude pelvic organ lesions and bladder lesions. (2) Grading and evaluation of pelvic organ prolapse Patients in maximal prolapse (maxium prolapse) were scored by POP-Q. The degree of pelvic organ prolapse is determined based on the results of the measurement of 6 measurement points and 3 diameter lines. Currently, the POP-Q (Pelvic organ Prolapse quantitive examination) evaluation system was developed by the American College of Obstetrics and Gynecology in 1995.