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LINK XEM BONG DA TRUC TUYEN; TRUC TIEP. Làm truc tiep bong da t. Truyền Hình Internet Việt NamReleased as a sequel to the 1. Mario Bros., Super Mario Bros. In Super Mario Bros., the player controls Mario and in a two- player game, a second player controls Mario's brother Luigi as he travels through the Mushroom Kingdom in order to rescue Princess Toadstool from the antagonist Bowser. Super Mario Bros. In 2. 00. 5, a poll by IGN named the . In addition to its definitive features, the game has also sold well, and was the best- selling game of all time for a single platform for approximately three decades at over 4. Nintendo's Wii Sports took that title in the late 2.
See Exclusive Content in 3D on your Nintendo 3DS Browser; Iwata Asks: The Making of Super Mario 3D Land; View Trailers, Screenshots, & Wallpapers. Official New Super Mario Bros. Screenshots, previews, strategies, and downloads. Get all the official details on Super Mario 3D World from Nintendo. Check out trailers and screenshots, learn about game features, and more. Play Super Mario Bros. Super Mario Brothers 3 played on the old school nintendo console (Super Nintendo), some of you might remember playing it. The commercial success of Super Mario Bros. Nintendo released special red variants of the Wii and Nintendo DSi XL consoles in re- packaged, Mario- themed limited edition bundles in late 2. The game's success led to a series of sequels and an expansive franchise, including adaptations into a television series, an anime, and a full- length feature film. Plot. Super Mario Bros.'s plot is told in the game's instruction manual. The peaceful people of the Mushroom Kingdom are suddenly attacked by a tribe of turtles called the Koopa Army, led by the villainous King Bowser. Using Bowser's signature . The tribe also kidnaps Princess Toadstool, the daughter of the Mushroom King and the only one with the ability to reverse Bowser's spell. After hearing the story, the plumber Mario sets out on a quest to save the princess and free the kingdom from the Koopa. Mario then enters a room and frees the princess, and the Mushroom Kingdom is let free of the Koopa's reign. Mario's abilities can be changed by picking up certain items; for example, Mario is able to shoot fireballs if he picks up a Fire Flower. The player takes on the role of the main protagonist of the series, Mario. Mario's younger brother, Luigi, is only playable by the second player in the game's multiplayer mode and assumes the same plot role and functionality as Mario. The objective is to race through the Mushroom Kingdom, survive the main antagonist Bowser's forces, and save Princess Toadstool. If the player gains a red and yellow Super Mushroom, Mario grows to double his size and can take one extra hit from most enemies and obstacles, in addition to being able to break bricks above him. One life is lost when Mario takes damage while small, falls in a pit, or runs out of time. The game ends when all lives are lost. Mario's primary attack is jumping on top of enemies, though many enemies have differing responses to this. For example, a Goomba will flatten and be defeated. Another is the Fire Flower; when picked up, this item changes the color of Super Mario's outfit and allows him to throw fireballs, or only upgrades Mario to Super Mario if he has not already. A less common item is the Starman, which often appears when Mario hits certain concealed or otherwise invisible blocks. This item makes Mario temporarily invincible to most hazards and capable of defeating enemies on contact. The game also includes some stages taking place underwater, which contain different enemies. In addition, there are bonuses and secret areas in the game. Most secret areas contain more coins for Mario to collect, but some contain . The development of Super Mario Bros. Originally, the game was based around a shooting mechanic with very different controls. Unlike in Mario Bros., where Mario would be hurt by stomping on turtles without first flipping them on their backs, Mario could defeat turtles by stomping on their shells, as the developers decided the previous method had been illogical. The ability to have Mario change size was a result of basing level design around a smaller Mario, then intending to make his size bigger in the final version. They later decided it would be fun to have Mario become bigger as a power- up. The early level design was focused on teaching players that mushrooms were distinct from Goombas and would be beneficial to them: In the first level of the game, the first mushroom is difficult to avoid if it is released. The opening sections of Nintendo Entertainment System games such as Metroid, The Legend of Zelda and Super Mario Bros. Rather than confront the player with obstacles, the first level of Super Mario Bros. According to Miyamoto, once the player understands the mechanics of the game, the player will be able to play more freely and it becomes . World 1- 2 contains a hidden warp zone, with warp pipes that transport the player to worlds 2, 3, and 4, accessed by running over a wall near the exit. If the player is able to exploit a bug that allows Mario to pass through bricks, the player can enter the warp zone by passing through the wall and the pipe to World 2- 1 and 4- 1 may instead transport the player to a stage labeled . This stage's map is identical to worlds 2- 2 and 7- 2 and upon entering the warp pipe at the end, the player is taken back to the start of the level, thus trapping the player in the level until all lives have been lost. Although the level name is shown as . After completing these levels, the player returns to the title screen as if the game were completed. Kondo's work on Super Mario Bros. He wasn't the first to do this, for example, Space Invaders has a simple song that gets faster and faster as the aliens speed up, eliciting a sense of stress and impending doom that matches the increasing challenge of the game. Kondo wrote the score with the help of small pianos for an appropriate melody of this scene. After the development of the game showed progress, he realized that his music did not quite fit the pace of the game, so he changed it a bit by increasing the tempo. A side- scrolling platform game entitled Super Mario Bros. In Japan, Super Mario Bros. This game is one of several made for Nintendo's NES- based arcade cabinet, the Nintendo Vs. Unisystem (and its variant, Nintendo Vs. Some stages are different; the early stages have small differences like the omission of 1- up mushrooms and other hidden items, narrower platforms and more dangerous enemies, but later stages are changed entirely. These changes have a net effect of making Vs. Many of these changed stages reappeared in the 1. Super Mario Bros. The game, which was only released in Japan for the Famicom Disk System (and in turn is extremely rare). The creators altered the sprites of the enemies, mushroom retainers, and other characters to look like famous Japanese music idols, recording artists, and DJs as well as other people related to All- Night Nippon. They also used the same slightly upgraded graphics and physics that Super Mario Bros.: The Lost Levels used. It was published by Fuji TV, the same company that later published the game Yume K. Japan). Special. Super Mario Bros. Although it has similar controls and graphics, there are new level layouts and the game scrolls in a different manner than the original game (differing based on the computer). In addition, many new enemies are included, including enemies from Mario Bros. It includes remakes of all of the Super Mario Bros. The version of Super Mario Bros. Another new feature introduced in this game is the ability for the player to switch to Luigi after the end of the stage, unlike in the original Super Mario Bros. The new version also included a save game feature. Several glitches from the original NES release were also fixed. Deluxe. Super Mario Bros. Deluxe cartridge for the Game Boy Color. Super Mario Bros. DX, was released on the Game Boy Color in 1. North America and Europe. Based on the original Super Mario Bros., it featured an overworld level map, simultaneous multiplayer, a Challenge mode (in which the player had to find hidden objects and achieve a certain score in addition to normally completing the level) and eight additional worlds based on the main worlds of the 1. Super Mario Bros. Super Mario All- Stars as Super Mario Bros.: The Lost Levels) as an unlockable extra, under the name . It also was compatible with the Game Boy Printer. The game featured a few minor visual upgrades (such as water and lava now being animated rather than static), and, since the screen resolution of the Game Boy Color was smaller than the NES, the view distance of the player is reduced. To compensate, players can press up and down to see above and below the player. Pressing select during the game also places the player in the middle or off to the left of the screen so that player can see well. Players can also go back for a very short distance instead of always going to the right. Players can alternate between Mario and Luigi by pressing select on the map screen. Fire Luigi, originally identical to Fire Mario, took on normal Luigi’s original colors to fit with his Fire colors in later games. The game holds an aggregate score of 9. Game. Rankings, coming in as the second best game on the Game Boy Color and the 1. He hoped that it would be the example for other NES games to follow when being ported to the Game Boy Color. Of that version, IGN noted that the version did not . Deluxe ranked third in the best- selling handheld game charts in the U. S. In Japan, users who registered a Nintendo Network ID on their Nintendo 3. DS system between December 1. January 1. 0, 2. 01. January 2. 7, 2. 01. The only playable character in the game is Luigi, with the same performance attributes he has in the Japan release of Super Mario Bros. If the two- player mode is played then both players play as Luigi. The game is based on a mission in NES Remix, featuring Luigi in a mirrored version of World 1- 2. Unlike previous re- releases, this version is emulated, containing no graphical updates and all of the original glitches remain. The only known way to unlock Super Mario Bros. The game was released on December 2, 2. Japan, December 2. North America and January 5, 2. PAL regions for Wii's Virtual Console. As with the Game Boy Advance release, it is an emulation of the original game, so nothing is changed from the original NES release. The game was released for the Wii U Virtual Console in Japan on June 5, 2. Europe on September 1. North America on September 1. Developer Interview. Fami. Connichiwa, everyone! I'm Akinori Sao, a writer in Kyoto. This is my third interview with video game developers to commemorate the release of the NES Classic Edition system. The topic this time is Super Mario Bros., the most representative game of the original Famicom/NES. As you may know, the Super Mario Bros. For example, the Iwata Asks sessions covering the New Super Mario Bros. Wii game (Volumes 1& 2) and the 2. Super Mario (Volume 5: Original Super Mario Developers) come to mind. These are all great reads, so if you haven't checked them out, please do! This time, in addition to the first Super Mario Bros. Nearly five years later in North America). I will be talking with Shigeru Miyamoto, who I also interviewed about Donkey Kong, as well as designer Takashi Tezuka and sound designer Koji Kondo. We're sure to hear the development challenges of Super Mario Bros. And now for Miyamoto- san, Tezuka- san and Kondo- san. At that time, the Famicom was already on sale. Tezuka: That's right. Nintendo had released the Famicom the year before, in 1. Editor's note: The NES, the version of the Famicom sold outside of Japan, was released in 1. Did you have one? Tezuka: Um, no. I played a lot of arcade games though. The Famicom version was released in July the following year, and later for NES! It's hard to believe that someone like me, who was so unknowledgeable, would end up developing games for the Famicom/NES. Our topic today is Super Mario Bros. Miyamoto- san, what was your approach toward this game? Miyamoto: I wanted to make a game that would be the culmination of all NES cartridge games up to that point. From the release of the original Famicom until the release of this game—which would go on to become a worldwide hit—it took two years. Did the participation of Tezuka- san and Kondo- san play a big role in making it happen? Miyamoto: Yes. I was doing design work all on my own, so Tezuka- san's arrival was a big help. The first game we made together was Devil World. The game was later released for NES in European regions. Kondo- san, that game was also your debut work, wasn't it? Kondo: Yes. Miyamoto: Later, we made Excitebike. NES Classic Edition. Tezuka- san helped a little that time, too. And all of that accrued technology was at work in the development of Super Mario Bros. Miyamoto: That's right. We wanted to pack various technologies into one Famicom cartridge game, like a puzzle. So we ended up making the player character larger, and creating long courses that scroll. The Family Computer Disk System. Family Computer Disk System: A peripheral product for the Famicom system released in February 1. The floppy disks used with the system had greater memory than ROM cartridges, allowing players to save game data. This system was sold only in Japan. Miyamoto: That's why I really wanted to make Super Mario Bros. We had built up a lot of know- how since the release of the console, and the time had come when that would be possible. From Big Mario to Small Mario. Tezuka- san, when you started working on Super Mario Bros., what sort of concept did Miyamoto- san lay out? Tezuka: He said he wanted to make gameplay in which a large player- character would run and jump around fairly large courses. So at first, you just controlled a big Mario. Tezuka: Yes. Quite a long time ago, a manga magazine had stories about the development of Super Mario Bros. Miyamoto: Yes, that's right. Tezuka- san and Nakago- san. I were having a meeting, and we had the length of all the courses drawn up on a whiteboard. We were discussing whether there was any way to see farther ahead. Toshihiko Nakago: President, SRD Co., Ltd. SRD is a company that contracts to develop video game software and develops and sells CAD packages. For many years, SRD has been involved with development of the Super Mario. We could pull back for a broader view, but then Mario would be smaller. Then Nakago- san said, . Wouldn't it be fun to have a small Mario, too? You introduced a smaller Mario to make it easier to see what's ahead in the course. Miyamoto: Yes. And then we decided that you'll lose a turn when the smaller Mario runs into an enemy, when big Mario runs into an enemy, he would just get smaller. That would be a brand- new game mechanic, and we decided to go with it right away in that meeting. So the inspiration didn't come from a bug as in the manga. Tezuka: Yes. Miyamoto: And since Mario had gotten bigger, we added . Miyamoto: All right. Super Mario Bros. Super Mario Bros. How did that come about? Miyamoto: The game before that, Super Mario Bros.: The Lost Levels. Tezuka- san's directorial debut. That went well, so we decided to make a completely new game. Japan for the Famicom system in June 1. It looked and played very similar to the first Super Mario Bros., but with a tougher challenge level developed for advanced players. Tezuka- san, did you feel pressure as the director of Super Mario Bros. After all, the original Super Mario Bros. But it wouldn't come together well and dragged on. Miyamoto: And Nakago- san got angry. But we couldn't do it well. Miyamoto: He said he wanted to look from a little above. But in Super Mario Bros. With a diagonal view from slightly overhead, you lost your sense of distance to the ground. So I told him that development would be difficult. Tezuka: Yeah, it was. Tezuka: We made Super Mario Bros.: The Lost Levels by changing the original game's difficulty and stage design, but we couldn't do that again, so I wanted to change everything, including its general appearance. So that's why you kept attempting new things like trying a bird's- eye view and outlining the characters in black. Tezuka: Yes. Miyamoto: Mario's face changed a lot, too. His eye was now one dot away from his cap, so he looked cuter. Tezuka: The original Mario's eyes and hat were conjoined, so I wanted to change that, too. Mario has more actions, too. Tezuka: Yeah. A tail seems a bit forced, so I really worried over that. I kept wondering if Mario and a raccoon was the right match. Why a raccoon tail? Tezuka: Because I wanted to put in a new action where players could press a button to have Mario spin around and knock enemies out of the way with his tail. You originally gave him a tail so he could blow away enemies rather than fly. That's why you chose a raccoon? Tezuka: Yes. When we switched from a bird's- eye view back to a side view, the controls didn't work well and making adjustments was a challenge. Flying was something I had wanted to do since the first game, and Raccoon Mario ended up being able to do both. Miyamoto: So Raccoon Mario was there from relatively early on. And then there's Frog Mario. In the spring of the following year, we were finally able to apply the final polish. Tezuka: Yes, that's about right. Miyamoto: So it took about two years. We wanted to release it in spring of 1. What caused such trouble? Tezuka: Well, we wanted to put in a lot of stuff. There were all these things we wanted to do, but once all the features were placed together, there were a lot of holes that needed to be patched up. How many people made the original Super Mario Bros.? Miyamoto: I think it was about seven or eight people. How about Super Mario Bros. Tezuka: Quite a lot more. Miyamoto: Maybe 2. Tezuka: Yes, about that many. Miyamoto: We had what we called the Map Room, a long, narrow meeting room where the programmers would line up, look at sheets of paper, and program map data every day. Tezuka: Yeah. Miyamoto: Toward the end, we made it engaging in human wave tactics with help from a lot of people. Kondo: . Instead, I just played the game and made music that went along with it. But as more people heard it, they started saying it sounded Latin or like fusion, and I wondered what direction to take with Super Mario Bros. You began by thinking about the genre. Kondo: Yes. People even guessed it was going to be reggae! You were uncertain. Kondo: So I made two ground themes. And just before completion, I had these two listen to them and asked which we should use. Working on the music for Super Mario Bros. The original Super Mario Bros. NES Classic Edition. Kondo- san, what do you hope players will enjoy? But by the time we developed Super Mario Bros. We could now use sounds like percussion and timpani, so the music became much richer compared to the original Super Mario Bros. They're both in the NES Classic Edition, so it's easy to compare. Kondo: Right. Tezuka- san, what do you hope players will enjoy? Tezuka: I hope it will bring back memories for people who played it way back when. In particular, we put a lot of courses in Super Mario Bros. You get hasty. Tezuka: But each course is packed full of game elements, so I hope players will play each course again and again to the fullest. Especially since it took so long to make them! Even better, you have four for each of the 3. You can practically save wherever you want. Miyamoto: So I hope players will save all they want to relieve the stress they felt before. Packing In Over Ten Years of History. The NES is a piece of hardware that had a long life. Of the games included in the NES Classic Edition, Donkey Kong first came out in 1. Famicom, and the last one to come out was Kirby's Adventure. Also, a lot of new talent joined, which was important for continuing to do new things. Even people who weren't originally in the gaming industry, like Shigesato Itoi. Shigesato Itoi: In addition to being a copywriter and essayist, he has been integral to the development of video games such as the Earthbound. He runs Hobo Nikkan Itoi Shinbun, a Japanese online publication. Miyamoto: That's right. The original Super Mario Bros. Besides, the NES9 wasn't released in America until after Super Mario Bros. The NES was released in America on October 1. That's two years after Japan. At the time when you made Super Mario Bros., you had a strong sense of it as the culmination of Famicom cartridges. But you might say that was when it all began. Miyamoto: Yes. After Super Mario Bros., I met a lot of people and had a lot of experiences. Nintendo 3. DS. Bowser has once again kidnapped Princess Peach, but this time, Mario has another objective. The Mushroom Kingdom is bursting with more gold coins than before. Each level is littered with gold as coins rain down from overhead pipes, trails of coins are left behind special gold enemies and gold pipes transport Mario into coin- filled caverns. It's up to players to collect as many coins as possible throughout their adventure. Vaginal Prolapse Repair - Cystocele, Rectocele and Enterocele Repair. Organs will prolapse (fall out) when there is a loss of support (damage to the connective. Rectal prolapse surgery is done to repair protrusion of the rectal lining through the anus. Learn about techniques, risks and results. Surgery For Pelvic Organ Prolapse A Historical PerspectivePelvic mesh devices hit by allegations of research fraud, experimental surgery on thousands of women. Treating a pelvic organ prolapse. There are several treatment options available for a pelvic organ prolapse, depending on your circumstances. Pelvic Organ Prolapse Causes and Types. What is pelvic organ prolapse? Pelvic organ prolapse occurs when a pelvic organ- such as your bladder- drops (prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. This can happen when the muscles that hold your pelvic organs in place get weak or stretched from childbirth or surgery. Many women will have some kind of pelvic organ prolapse. It can be uncomfortable or painful. But it isn't usually a big health problem. It doesn't always get worse. Mesh Surgery For Pelvic Organ ProlapsePatients may present. Continued How is pelvic organ prolapse diagnosed? Your doctor will ask questions about your symptoms and about any pregnancies or health problems. APOPS provides international pelvic organ prolapse support and guidance. Pelvic organ prolapse (POP), also known as female genital prolapse, is characterized by descent of female genital organs beyond their normal anatomical confines. Pelvic organ prolapse (POP) is not a dangerous medical condition. Treatment options range from doing nothing and observing your condition over time to. Pelvic organ prolapse, or genital prolapse, is the descent of one or more of the pelvic structures (bladder, uterus, vagina) from the normal anatomic location toward. And in some women, it can get better with time. More than one pelvic organ can prolapse at the same time. Organs that can be involved when you have pelvic prolapse include the: What causes pelvic organ prolapse? Pelvic organ prolapse is most often linked to strain during childbirth. Normally your pelvic organs are kept in place by the muscles and tissues in your lower belly. During childbirth these muscles can get weak or stretched. If they don't recover, they can't support your pelvic organs. You may also get pelvic organ prolapse if you have surgery to remove your uterus (hysterectomy). Removing the uterus can sometimes leave other organs in the pelvis with less support. Pelvic organ prolapse can be made worse by anything that puts pressure on your belly, such as: Older women are more likely to have pelvic organ prolapse. It also tends to run in families. What are the symptoms? Symptoms of pelvic organ prolapse include: Feeling pressure from pelvic organs pressing against the vaginal wall. This is the most common symptom. Feeling very full in your lower belly. Feeling as if something is falling out of your vagina. Feeling a pull or stretch in your groin area or pain in your lower back. Releasing urine without meaning to (incontinence), or needing to urinate a lot. Having pain in your vagina during sex. Having problems with your bowels, such as constipation. Continued. How is pelvic organ prolapse diagnosed? Your doctor will ask questions about your symptoms and about any pregnancies or health problems. Your doctor will also do a physical exam, which will include a pelvic exam. How is it treated? Decisions about your treatment will be based on which pelvic organs have prolapsed and how bad your symptoms are. If your symptoms are mild, you may be able to do things at home to help yourself feel better. You can relieve many of your symptoms by adopting new, healthy habits. Try special exercises (called Kegels) that make your pelvic muscles stronger. Reach and stay at a healthy weight. Avoid lifting heavy things that put stress on your pelvic muscles. It is a removable device that you put in your vagina. It helps hold the pelvic organs in place. But if you have a severe prolapse, you may have trouble keeping a pessary in place. Surgery is another treatment option for serious symptoms of pelvic organ prolapse. But you may want to delay having surgery if you plan to have children. The strain of childbirth could cause your prolapse to come back. You may want to consider surgery if: You have a lot of pain because of the prolapsed organ. You have a problem with your bladder and bowels. The prolapse makes it hard for you to enjoy sex. Types of surgery for pelvic organ prolapse include: Surgery to repair the tissue that supports a prolapsed organ. Surgery to repair the tissue around your vagina. Surgery to close the opening of your vagina. Surgery to remove the uterus (hysterectomy). Pelvic organ prolapse can come back after surgery. Doing Kegel exercises to make your pelvic muscles stronger will help you recover faster from surgery. The two together can help you more than surgery alone. Frequently Asked Questions. Web. MD Medical Reference from Healthwise. This information is not intended to replace the advice of a doctor. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Pelvic organ prolapse - Treatment. There are several treatment options available for a pelvic organ prolapse, depending on your circumstances. The treatment most suitable for you depends on: the severity of your symptoms the severity of the prolapse your age and health whether you're planning to have children in the future You may not need any treatment if your prolapse is mild to moderate and not causing any pain or discomfort. The various treatments for pelvic organ prolapse are outlined below. You can also read a summary of the pros and cons of the treatments for pelvic organ prolapse, allowing you to compare your treatment options. Self care advice. If your prolapse is mild, there are some steps you can take that may help improve it or reduce the risk of it getting worse. This may include: doing regular pelvic floor exercises (see below) losing weight if you're overweight, or maintaining a healthy weight for your build (you can check your body mass index (BMI) using the healthy weight calculator) eating a high- fibre diet with plenty of fresh fruit, vegetables and wholegrain bread and cereal to avoid constipation and straining when going to the toilet avoiding heavy lifting and standing up for long periods of time If you smoke, giving up will help, because coughing can make a prolapse worse. Read guidance on stopping smoking for more information. Pelvic floor exercises. The pelvic floor muscles are a group of muscles that wrap around the underside of the bladder and rectum. Having weak or damaged pelvic floor muscles can make a prolapse more likely. Recent evidence suggests that pelvic floor exercises may help to improve a mild prolapse or reduce the risk of it getting worse. Pelvic floor exercises are also used to treat urinary incontinence (when you leak urine), so may be useful if this is one of your symptoms. Read more about treating urinary incontinence. To help strengthen your pelvic floor muscles, sit comfortably on a chair with your knees slightly apart. Squeeze the muscles eight times in a row and perform these contractions three times a day. Don't hold your breath or tighten your stomach, buttock, or thigh muscles at the same time. When you get used to doing this, you can try holding each squeeze for a few seconds (up to 1. Every week, you can add more squeezes, but be careful not to overdo it and always have a rest inbetween sets of squeezes. Your doctor may refer you to a physiotherapist, who can teach you how to do pelvic floor exercises. It usually takes at least three months before you notice any improvement. Hormone replacement therapy (HRT)While there's little evidence that hormone replacement therapy (HRT) can directly treat pelvic organ prolapse, it can relieve some of the symptoms associated with prolapse, such as vaginal dryness or discomfort during sex. HRT increases the level of oestrogen in women who have been through the menopause. HRT medication is available as: a cream you apply to your vagina a tablet you insert into your vagina a patch you stick on your skin an implant inserted under your skin HRT is used for women with prolapse after menopause who have the symptoms described above. Creams, tablets or pessaries may be used for a short time to improve these symptoms. It works by holding the vaginal walls in place. Ring pessaries are usually made of latex (rubber) or silicone and come in different shapes and sizes. Ring pessaries may be an option if your prolapse is more severe, but you would prefer not to have surgery. A gynaecologist (a specialist in treating conditions of the female reproductive system) or a specialist nurse usually fits a pessary. The pessary may need to be removed and replaced every four to six months. Side effects Ring pessaries can occasionally cause vaginal discharge, some irritation and possibly bleeding and sores inside your vagina. Other side effects include: passing a small amount of urine when you cough, sneeze or exercise (stress incontinence) difficulty with bowel movements interference with having sex, although most women can have intercourse without any problems an imbalance of the usual bacteria found in your vagina (bacterial vaginosis) These side effects can usually be treated. Surgery Surgery may be an option for treating a prolapse if it's felt the possible benefits outweigh the risks. Surgery for pelvic organ prolapse is relatively common. It's estimated that 1 in 1. These procedures are outlined below. Surgical repair. One of the main surgical treatments for pelvic organ prolapse involves improving support for the pelvic organs. This may involve stitching prolapsed organs back into place and supporting the existing tissues to make them stronger. Pelvic organ repair may be done through cuts (incisions) in the vagina. It's usually carried out under general anaesthetic, so you'll be asleep during the operation and won't feel any pain. If you're planning to have children and have a prolapse, your doctors may suggest delaying surgery until you're sure you no longer want to have any more children. This is because pregnancy can cause the prolapse to recur. Vaginal mesh. Surgery for pelvic organ prolapse may not always be successful and the prolapse can return. For this reason, synthetic (non- absorbable) and biological (absorbable) meshes have been introduced to support the vaginal wall and/or internal organs. About 1,5. 00 such operations are carried out in the UK each year. The majority of women treated with mesh respond well to this treatment. However, the Medicines & Healthcare products Regulatory Agency (MHRA) has received reports of complications associated with vaginal meshes. These are mostly regarding persistent pain, sexual problems, mesh exposure through vaginal tissues and occasionally injury to nearby organs, such as the bladder or bowel. If you've recently had vaginal mesh inserted and think there may be complications, or you want to find out about the risks involved, speak to your GP. You can also report a problem with a medicine or medical device on the GOV. UK website. If you're thinking about having vaginal mesh inserted, you may want to ask your surgeon some of these questions before you proceed: What are the alternatives? What are the chances of success with the use of mesh versus use of other procedures? What are the pros and cons of using mesh, and what are the pros and cons of alternative procedures? What experience have you had with implanting mesh? What have been the outcomes from the people you have treated? What has been your experience in dealing with any complications that might occur? What if the mesh doesn't correct my problems? If I have a complication related to the mesh, can it be removed and what are the consequences associated with this? Do you know what happens to the mesh over time? Hysterectomy. If the womb (uterus) is prolapsed, then removing it during an operation called a hysterectomy often helps the surgeon to give better support to the rest of the vagina and reduce the chance of a prolapse returning. A hysterectomy will usually only be considered in women who don't wish to have any more children, as you can't get pregnant after having a hysterectomy. Methods to elevate and support the uterus without removing it do exist, but these need to be discussed with your doctor. Complications from surgery All types of surgery carry some risks. Your surgeon will explain these in more detail, but possible complications could include: risks associated with anaesthesiableeding, which may require a blood transfusiondamage to the surrounding organs, such as your bladder or bowel an infection – you may be given antibiotics to take during and after surgery to reduce the risk of infection pain during sex, usually caused by narrowing of the vagina vaginal discharge and bleeding experiencing more prolapse symptoms, which may require further surgery a blood clot forming in one of your veins (for example, in your leg) – you may be given medication to help reduce this risk after surgery (see deep vein thrombosis (DVT) for more information) Recovering from surgery. Most prolapse operations require an overnight stay in hospital. More major operations, such as a hysterectomy, may require a few nights in hospital. If you need to stay in hospital, you may have a drip in your arm to provide fluids and a thin plastic tube called a catheter to drain urine from your bladder. Some gauze may be placed inside your vagina to act as a bandage for the first 2. This may be slightly uncomfortable. Your stitches will usually dissolve on their own after a few weeks. You may also have some vaginal discharge. This may last three or four weeks. During this time, you should use sanitary towels rather than tampons. Enhanced recovery Enhanced recovery is an NHS initiative to improve patient outcomes after surgery and speed up recovery. This involves careful planning and preparation before surgery, as well as reducing the stress of surgery, by: using pain relief to minimise pain avoiding unnecessary drips, tubes and drains enabling you to eat and drink straight after your operation encouraging early mobilisation Post- surgery advice. Even with enhanced recovery, there may still be some activities you need to avoid while you recover from surgery. Your care team can advise about activities you may need to avoid, such as heavy lifting and strenuous exercise, and for how long. Generally, most people are advised to move around as soon as possible, with good rests every few hours. You can usually shower and bathe as normal after leaving hospital, but you may need to avoid swimming for a few weeks. It's best to avoid having sex for around four to six weeks, until you've healed completely. Your care team will advise about when you can return to work. Problems with recovery Contact your GP if you experience: a high temperature (fever) of 3. Pelvic Prolapse, Cystocele and Rectocele . Pessaries come in different sizes and may be made of rubber, plastic, or silicone- based material. There are many circumstances where we recommend pessaries including patients who have temporary prolapse symptoms due to pregnancy. We can discuss types of pessaries and make sure yours fits, offers relief and stays in position without causing discomfort. Medications for Pelvic Prolapse. Menopause results in lower estrogen levels, which weakens the tissues of the vagina. Estrogen therapy may improve the tissues. However, some people shouldn't use estrogen, so discuss risks and benefits with your doctor. Physical therapy for Pelvic Prolapse. Physical therapy may include pelvic floor exercises using biofeedback to strengthen specific muscles of the pelvic floor. Biofeedback involves the use of monitoring devices with sensors that are placed in your vagina, rectum or on your skin. As you perform an exercise, a computer screen shows whether you're using the right muscles and the strength of each squeeze (contraction) so you learn how to do the exercises properly. 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