This patient suffered from stress incontinence and prolapse of both the bladder, uterus, and rectum. This O.R. surgery started with a transoburator sling, then an anterior repair with dermal allograft, sacrospinous uterine suspension, then a rectocele/perineocele repair and perineoplasty, This was originally presented at the ISCG 2020 Congress in Fort Lauderdale.