(Disclaimer: This article is for general use only and the information in the following content has been processed to protect patient privacy) Abstract: A female patient, 43 years old, was diagnosed with severe uterine prolapse, a more serious type of pelvic organ prolapse, after clinical examination due to a vaginal mass for six months and a significant increase in the size of the vaginal mass in response to increased abdominal pressure such as coughing and stooling. After the family and the patient agreed, surgery as well as medication was given and the patient was discharged with no abnormalities in all examinations, good wound healing, no prolapse of the vulva mass and smooth vaginal wall. [Basic information] Female, 43 years old [Type of disease] Severe prolapse of uterus [Hospital] Guangzhou Huadu District People’s Hospital [Date of consultation] January 2020 [Treatment plan] Surgical treatment (total cervical hysterectomy, anterior vaginal wall repair surgery) + intravenous infusion (sodium chloride glucose injection, cefazolin sodium for injection) [Treatment cycle] Hospitalization for 15 days, postoperative review in 3 months [Treatment Results] No abnormalities in all examinations, good wound healing, no mass prolapsed from the vulva, smooth vaginal wall I. Initial interview 43-year-old female patient, menopausal 2 years ago, vaginal mass found in the last 6 months, with coughing or straining to relieve stool, the mass increased significantly. On examination: the patient has a body temperature of 36℃, heart rate of 78 beats/min, respiration of 18 breaths/min, blood pressure of 110/60mmHg, normal cranial development, normal facial features, normal cardiopulmonary auscultation, flat abdomen, and no palpation of liver and spleen. The patient had normal vulvar development, 2/3 of the vaginal orifice was seen to be prolapsed from the uterine body, the cervix was eroded, there was little vaginal discharge, no ulceration of the vaginal mucosa, the anterior vaginal wall was bulging beyond the hymenal edge, the uterus was completely prolapsed from the vaginal orifice when holding the breath downward, the uterus was slightly smaller than normal, no abnormalities were palpated in the bilateral adnexal areas, and no masses were palpated in the pelvis. Vaginal color ultrasonography showed no abnormalities in the bilateral adnexal areas. no intraepithelial lesions were seen on TCT, HPV test was positive for type 52, colposcopy suggested chronic inflammation of the cervix, and the preliminary diagnosis was severe prolapse of the uterus with anterior vaginal wall bulge. The patient was admitted to the hospital on January 10, 2020, and after completing various examinations, she underwent a total epidural hysterectomy with anterior vaginal wall repair under epidural anesthesia on January 14, 2020, and was given postoperative bed rest, glucose sodium chloride injection for rehydration and cefazolin sodium for injection for anti-infection treatment. After awakening from anesthesia, the patient was instructed to move the lower limbs and turn around after exhaustion to avoid thrombosis due to reduced activity. After the operation, the patient should scrub the vulva with iodophor twice a day, change the sanitary napkin in time, and strengthen the care of the urinary catheter, and remove the urinary catheter on the 7th day after the operation. After removal of the urinary catheter, avoid sitting for a long time, which may affect the healing of the vaginal stump. Half a month after the operation, she started to leave the bed and move around gradually for 3-5 minutes. After 15 days of hospitalization, the patient was discharged from the hospital. The patient was discharged with normal temperature, normal respiration, normal blood pressure, no abnormal heart and lung auscultation, flat and soft abdomen with no pressure pain, normal vulva with no swelling prolapse, smooth vaginal wall, no abnormal vaginal discharge, no odor, no bulge in the anterior vaginal wall, no redness and exudation in the vaginal stump, good wound healing, no bulge in the anterior and posterior vaginal walls with gentle breath holding, and normal limb movement. Precautions We are glad that the patient was discharged from the hospital after treatment, but we need to advise the patient to avoid frequent bed rest, drink more water, urinate regularly and flush the urethra repeatedly to avoid urinary tract infection. The main diet should be a light diet, with more food containing dietary fiber to avoid constipation and straining to remove stools. Avoid sexual intercourse and sitz baths for 3 months after surgery to avoid bleeding from the vaginal stump or local infection. Return to the hospital 3 months after surgery for a gynecological examination to check the healing of the vaginal stump and an ultrasound examination to see if there is fluid in the pelvic cavity. V. Personal insight Pelvic organ prolapse, especially uterine prolapse, is one of the common gynecological diseases, and the onset of this patient is mainly related to the history of childbirth and aging of the organ due to ageing. It is very important for women to do anal lifting exercises or pelvic floor rehabilitation after childbirth to reduce the chance of uterine prolapse and anterior and posterior vaginal wall bulge due to the decrease of pelvic floor muscle tone. Regular gynecological checkups can help to prevent the uterus from descending along the pelvic axis, causing severe prolapse and surgery, which can cause more damage to the body.