Uterine prolapse is defined as the descent of the uterus and cervix down the vaginal canal toward the vaginal introitus. All forms of genital prolapse are described in reference to the hymen. The uterine displacement is typically graded on a scale of 0 to 4, with 0 referring to no prolapse, 1 halfway to the hymen, 2 at the hymen, 3 halfway out of the hymen, and 4 referring to total proplapse.3 A first-degree or mild prolapse is defined with the cervix palpable as a firm mass in the lower third of the vagina. Patients with grades 0 or 1 prolapse are usually asymptomatic. Grade 3, or moderate prolapse, is characterized by the cervix being visible and projecting into or through the vaginal introitus. The patient may experience a falling-out sensation or may report the feeling of sitting on a ball. Additional symptoms include heaviness in the pelvis, low backache, lower abdominal discomfort, and inguinal discomfort. Grade 4, also known as severe prolapse or procidentia, involves the cervix and entire uterus projecting through the introitus, completely inverting the vaginal vault (Figure 141-1).9 The uterine mass frequently has one or more areas of easily bleeding atrophic lesions secondary to exposure and local pressure effects. It may result in leukorrhea, abnormal uterine bleeding, or spontaneous abortions.5