New insights classification systems have modified previously held beliefs in the field of pelvic organ prolapse. POP is a vast and amorphous field of surgery. Different causes of prolapse and a host of confounding variables makes one approach and any one standard procedure unscientific. The “one – operation fits all” methods of the past must be eschewed, and a more thoughtful and evidence – based approach cultivated. If necessary, specialist knowledge and expertise may need to be consulted in an approach to difficult cases of POP.