Many women with age or after illness suffer from the problem of prolapse or prolapse of the uterus - prolapse. Such a phenomenon not only causes physical and psychological discomfort, but also is fraught with the emergence of various diseases. When surgical intervention is impossible, a special device - a gynecological ring (pessary) - is designed to solve the problem. The article describes the indications, effect, advantages and disadvantages of this method of treatment of prolapse.
A pessary is a silicone or latex ring that is put on the cervix, supporting it in the desired position. The material of the device is hypoallergenic and safe for health. The pessary has sufficient elasticity to take a position in the vagina that does not cause discomfort. This device acts as a support for the uterus, not allowing the body to shift to an unnatural position. Properly chosen ring will help to return to the old rhythm of life and normalize the processes occurring in the body.
Types of gynecological rings
Pessaries differ depending on the stage of uterine prolapse, the anatomical nuances, the presence of associated problems with urination. In medical practice, the following types of devices are used:
- Thin and thick rings. Used in light and medium degrees of prolapse, when the cervix is lowered below the narrow part of the pelvis, but not shown outwards, as well as in cases when a change in the position of the walls of the vagina is observed. The rings are produced with a diameter of 50 to 100 mm in 5 mm increments.
- Cup pessary (perforated). It is used for mild and moderate stages of uterine prolapse. It has the shape of a bowl with a hole inside with an outer diameter of 50 to 95 mm with a difference of 5 mm each. The perforated pessary additionally contains small holes.
- Urethral In addition to the prolapse of the uterus, is also used in the presence of problems with uncontrolled urination. It has the shape of a ring with a thickening outward, which provides support for the urethra, with a diameter of 45 to 100 mm in 5 mm increments.
- Cup-urethral. Combines the elements of the two previous types. Available in diameters from 55 to 90 mm. It is designed to fix the uterus with mild or moderate omission and control urination.
- Pessary hoxha. Presented in the form of a ring of irregular shape, may take a different position. This type is used for the treatment of severe stages of prolapse, in cases of certain anatomical features of the structure of internal organs, when it is inappropriate to install standard types of pessaries. Hodge ring sizes range from 55 to 95 mm.
- Cervical perforated. It has the shape of a bowl with a large hole in the center and small around the perimeter. It is used with moderate severity of prolapse, as well as to preserve pregnancy in women with a short neck length.
- Cubic and cubic perforated. Designed for use in severe stages of prolapse. You can wear them only 6-12 hours. The fixture is made in the form of a regular hexagon with concave sides and rounded corners. Contains a thread for easy removal from the vagina. Sizes can be in the range from 25 to 45 mm. The perforated type contains holes for excretion.
- Mushroom pessary. It looks like a mushroom on the leg with a thickening at the bottom, which helps to keep the ring in the vagina. The use of this type is carried out in the absence of the possibility to establish standard pessaries in the severe stages of uterine prolapse. Wearing such a device is permitted for a short time (6-12 hours). At night it should be removed. The diameter varies from 50 to 90 mm.
Indications for use
When diagnosing uterine prolapse, doctors strongly recommend installing a pessary in the following cases:
- Refusal of the patient from surgery or its impossibility due to old age and other reasons.
- The need to treat inflammation, genital infections before surgery.
- Urinary incontinence.
- Prevent preterm labor.
- Monitoring the recovery process after surgery.
There are cases in which the installation of the uterine ring is contraindicated in the patient. These include the following:
- allergic to components of the device,
- cervical erosion,
- genital pathologies,
- bleeding unknown nature
- education in the pelvic area,
- neck inflammation,
- the presence of infections.
In addition, women may experience psychological discomfort from wearing a foreign body in the vagina, which can prevent the passage of a course of treatment.
Advantages and disadvantages of using uterine rings
The advantages of using pessary include:
- Ability to get rid of prolapse without surgery.
- Correction of the position of the uterus at different stages.
- Preventing organ injury risk.
- The ease of treatment with the correct choice of the type of device.
Despite the weighty list of positive aspects, there are also disadvantages in the use of gynecological rings, forcing patients to abandon this method of treatment. Among them note the following:
- The risk of inflammation of the urethra and the walls of the vagina at the point of contact with the pessary. In elderly patients, the mucosa is more susceptible to infections.
- The need to try several different types of pessaries to determine the most appropriate, which is quite expensive and inconvenient.
- Wearing discomfort due to improper size or increased amount of discharge.
How to install the uterine ring and how to wear it
Devices are supplied non-sterile, so before installation they must be washed and disinfected. For ease of administration and to prevent injury to the patient, the pessary is smeared with a vaginal cream. The doctor returns the lowered organs to the desired position and inserts the bent ring into the vagina. Inside the pessary is straightened and placed at the neck of the organ.
Almost all uterine devices (except cubic and mushroom) are installed for a period of 30-40 days. After the first injection, the patient is examined after 10-14 days to assess the condition of the mucous. The examination is repeated after one month, then every 90 days.
According to the patient reviews, the gynecological ring is an effective treatment for prolapse. The use of a pessary will help not only delay the surgery, but also completely eliminate its need. The main thing - to choose the type and size of the device, follow the recommendations of the doctor and perform exercises to strengthen the muscles of the pelvic floor.
Ring for the uterus is a gynecological and obstetric equipment, made of elastic, safe and hypoallergenic plastic. The best are products made of silicone, polyvinyl chloride and latex. Pessaries are inserted into the vagina and shown to maintain the uterus in an anatomically correct position. The product plays the role of support, a kind of crutch for an organ, a supporting element, but is not an independent medical measure. Used in complex therapy.
The gynecological ring, when the uterus is lowered, keeps the organ in any movement of the body, allows you to lead an active lifestyle, does not fall out when moving.
Pessaries are shown in the following cases:
- Grade 3 prolapse - at the exit of the uterus into the vagina,
- 4th degree prolapse - with complete organ prolapse,
- with the impossibility of surgical treatment,
- patient's desire to postpone surgical treatment,
- identifying the causes of urinary incontinence,
- pregnancy with miscarriage,
- during preparation for extirpation and in the postoperative period.
Wearing a ring when the uterus is lowered can be long. The initial course is 1 month, then a break is taken. Further at the discretion of the gynecologist.
Classification of uterine rings
Developed various forms of uterine pessaries. When buying medical equipment for conservative treatment of uterine prolapse, it is necessary to choose the gynecological type of uterine ring, since obstetric is indicated for use in miscarriage.
On appearance, the gynecological pessary is a plastic ring with a diameter of 50 to 100 mm. Choose the necessary therapeutic device will help the doctor based on the diagnosis of the patient.
When prolapse of the pelvic organs use the types of rings shown in the photo:
- Cup - a form in the form of a bowl with perforations for the outflow of vaginal secretion - is shown during the initial stages of the disease. There is a variation of this type of device with several small holes.
- Urethral - supports the body of the uterus and urethra in the physiological position. This plastic ring with a thickening is shown with prolapse, accompanied by urinary incontinence.
- Cup-urethral - combined version. Shown in the initial stages of prolapse of the pelvic organs, accompanied by urinary incontinence.
- Cubic - has the shape of a cube with concave walls. This type of gynecological equipment is shown at stages 3 and 4 of the prolapse of the uterus. Duration of use is not more than 12 hours. At night, the device is removed. There is a variation of a pessary with several perforations for removal of biological fluids.
- Mushroom - appearance corresponds to the name. Shown with stage 4 disease. At night is not used.
- Rings of different thickness - prescribed with a slight omission of the pelvic organs.
- Hodge device - shown when it is impossible to use other forms of pessaries. This asymmetrical ring takes the desired configuration already in the patient's body.
It is impossible to independently determine the type of medical equipment for maintaining the pelvic organs in a physiological position. Uterine rings in case of prolapse of the uterus are produced in different sizes. The wrong shape and diameter of the medical equipment will do more harm than good.
When the uterus is lowered, the doctor selects the rings according to the diagnosis and structure of the patient's reproductive system. Acquire medical equipment should be in specialized outlets or large pharmaceutical networks.
Rules for installing and using rings
A pessary during the prolapse and descent of the uterus is installed and removed by the doctor during a pelvic exam. Then he offers the patient to do all the manipulations under his supervision.
Methods of using medical equipment for prolapse of the reproductive system:
- Before installation, the pessary should be thoroughly cleaned and treated with an antiseptic. Do not use alcohol-containing drugs. Ethanol can damage the structure of the material from which medical equipment is made. It is best to follow the recommendations of the gynecologist.
- To facilitate the introduction of the device lubricated with lubricant or petroleum jelly.
- Set in the correct physiological position of all organs. Then start the procedure for introducing the uterine ring.
- The pessary is squeezed with one hand and inserted into the vagina. Straighten the uterine ring in case of prolapse of the uterus directly in the neck of the organ
- In a hospital, this procedure is carried out by a doctor in a manipulation room. At home, you should lie on your back and bend your knees.
After that, the patient can get up. The device should not cause discomfort, to feel like a foreign body, to press or slide out when urinating or defecating.
If there are signs of discomfort or any other unpleasant symptoms - pain, cracks, excessive secretion or the appearance of blood - the device is removed.
1.5 weeks after the installation of gynecological equipment should contact the gynecologist to assess the condition of the mucous membranes of the vagina, cervix, the reaction of internal organs to a foreign object. Repeated reception is carried out in a month, then it will be necessary to appear at the gynecologist 1 time in 3 months.
Important! Mushroom and cubic pessary should be removed overnight. All other forms are allowed to use within 30 days.
When is it forbidden to use a pessary?
There are a number of contraindications to the use of supporting medical equipment in the treatment of uterine prolapse.
Uterine rings in case of prolapse of the uterus are contraindicated in the following categories of patients:
- individual intolerance of the ring material,
- anomalies of reproductive organs,
- colpitis, other pathologies,
- neoplasms of any origin,
- bleeding from the vagina of any etiology.
During treatment with the help of uterine rings, there is a likelihood of inflammatory processes in the urinary system. This is due to the constant pressure of the medical device on nearby organs. Failure to follow the rules of pessary treatment increases the risk of infection of the reproductive system organs with pathogenic flora.
Advantages and disadvantages
The use of medical equipment in the treatment of prolapse of the pelvic structures has both positive aspects and a number of disadvantages.
Positive sides of pessary:
- alternative body extirpation,
- effectiveness with varying severity of the disease,
- there is no risk of injury to the pelvic organs,
- the installation procedure is not invasive, does not require a hospital stay,
- ease of use.
Despite the convenience, simplicity and proven clinical efficacy, the use of uterine rings has a number of negative consequences.
Negative aspects of using equipment:
- development of inflammatory processes in the vagina, cervix,
- discomfort when using,
- difficulties in intimate life,
- stretching of the walls of the vagina, which increases the risk of damage by pathogenic flora,
- psychological discomfort due to the awareness of the presence of extraneous equipment in the vagina.
The diagnosis of uterine prolapse does not mean that the patient is doomed to discomfort, pain, and an organ removal procedure. The installation and use of the pessary, along with the performance of a complex of physical therapy, can not only delay surgery, but also completely eliminate the issue of uterine extirpation.
Essence of pathology
The genital organ in the pelvic cavity is held by the ligamentous apparatus and the muscular system. If the tone of the muscles and ligaments weakens, the organ begins to change its anatomical position, going down below.
The situation is aggravated by pressure on the uterus of the other organs of the pelvic and abdominal cavity. At the same time, the uterus itself begins to exert increased pressure on the rectum and bladder, thereby provoking various pathologies in these organs - difficulty urinating, cystitis, constipation, fecal incontinence, and so on.
Doctors distinguish the following degrees of the pathological process:
- the first degree - the omission of the organ is insignificant, the cervical area is approaching the genital slit, but does not go outside,
- second degree - a more significant prolapse, in which, when straining or coughing, the cervical region may extend beyond the vaginal limits,
- third degree - incomplete prolapse of the reproductive organ. Outside the vagina stands cervical region and part of the uterus,
- fourth degree or full prolapse - the uterus is completely out of the vagina.
What is a pessary?
Simply put, a pessary (scribal) is an elastic ring that is actively used in gynecological practice for various pathologies, including the prolapse of the uterus.
The gynecological ring is made of biologically pure and safe materials. Most often it is silicone or special plastic, which has high plasticity. Such materials easily take the form of female genitals, which means their use will not cause discomfort.
Pessary is sold sterile, but before buying the product, you must check the expiration date. All edges of the ring are smooth, they tightly fit the cervix, keep it from prolapse and prevent its disclosure.
The device has openings for vaginal discharge.
Why is it needed?
Of course, surgical treatment of prolapse (for example, when a mesh is installed) is the best way to solve the problem of prolapse of the uterus, but in most cases it is used in relatively young patients.
Elderly women surgery is assigned less frequently. This is due to various contraindications and background diseases of patients. In this case, prolapse is most often diagnosed after menopause, which is caused by involutional processes occurring in the woman’s body.
Conservative techniques do not always give a positive result, and then the pessary is the most effective alternative to surgical treatment of prolapse.
Медицинские технологии не стоят на месте, и в настоящее время появляются новые материалы и формы пессария, что делает это приспособление все более популярным и востребованным.
Advantages and disadvantages
Among the advantages of the pessary are:
- partial compensation of prolapse,
- the ability to lead a full life without surgery,
- ease of use and care,
- safety and hypoallergenic,
- if the device is chosen correctly, the risk of injury to the soft tissue is completely absent.
However, there are negative aspects of using the pessary:
- wearing volume may increase when wearing the ring
- intimate contact possible
- the inability to use in inflammatory processes of the pelvic organs. This is despite the fact that its long wearing is indicated for older women, in whom the mucosa naturally atrophies, which increases the risk of infection,
- In rare cases, there is a psychological barrier - a woman cannot tolerate the presence of a foreign object in the vagina.
When is the installation of uterine ring required?
Installation of a pessary is necessary in the following cases:
- uterine problems that are not accompanied by other pathologies,
- the inability or desire of the patient to perform surgery,
- It is possible to cure existing gynecological defects without surgery,
- it is necessary to evaluate the effect of the operation,
- in the diagnosis of urinary incontinence.
It is recommended to use this device at the initial stage of the disease.
What are the types?
The main types of pessary are as follows:
- supporting - supports the vagina, not allowing it to fall,
- thin - put on the cervix,
- cup-shaped - for the secretion of the genital glands,
- filling - does not allow uterine prolapse,
What kind of use is better, the doctor decides individually in each case.
The photo below shows the different types of these devices.
How is the installation
The initial installation of the uterine ring occurs in the gynecologist's office, in the future, the woman must learn to carry out this procedure independently.
Before the introduction of the ring it is sterilized or rinsed in boiling water. Then the ring is compressed, and inserted as deep as possible into the vagina so that the convex part of the ring is turned toward the neck.
This procedure is carried out in a horizontal position. If the ring is chosen and installed correctly, there should be no discomfort, and even more painful sensations.
After installing the pessary, the woman must visit the gynecologist two times a month to check the process and make sure that the device does not lead to complications.
Usually the ring is set for six months, but for older patients it is prescribed for life.
Not in all cases the uterine ring can be installed safely.
There are a number of contraindications that do not allow its use:
- precancerous condition of the uterus or cancer,
- genital infections,
- the presence of the inflammatory process.
Also, the installation of the uterine ring is not desirable for women who, for whatever reason, can not come to an appointment with a gynecologist at least once every six months.
Causes of prolapse of the internal urogenital organs in women
Prolapse is diagnosed by relaxing the muscles of the abdominal and small pelvis. This happens due to abdominal pressure, in which the ligaments lose their elasticity and become unable to hold the uterus, vagina and bladder.
For this reason, the muscle tone of the perineum is reduced and an omission occurs.
In women of age, the muscles supporting the uterus and holding the normal position of the walls of the vagina, stretch and genitals fall, sometimes completely falling out through the genital slit.
Also, the omission and premature opening of the uterus can be observed in women during gestational pregnancy and with uterine tone.
The factors affecting the development of prolapse of the genital organs in women, most often include:
- Long and difficult childbirth, with varying degrees of trauma. It should be noted that complicated births cause prolapse in almost half of the patients.
- Problems with connective tissue.
- Lowering sex hormones, especially this happens during menopause.
- Chronic pathologies that are accompanied by high intra-abdominal pressure (severe cough in bronchial asthma, regular constipation, etc.)
- Disturbances in the blood and lymph circulation of the pelvic organs.
- Reduced physical activity.
- Too much weight or dramatic weight loss.
- Certain cancers of the reproductive system.
- Regular, heavy exercise.
- Hereditary factor.
- Some women's operations and surgeries on nearby organs.
Types of pelvic organ prolapse in women
Anterior prolapse includes:
- Urethrocele (lower front wall of the vagina and urethra)
- Cystocele (diagnosed with a parallel prolapse of the anterior wall of the vagina and bladder)
- Cystoourtrocele (combines the two previous pathologies)
The above types of prolapse are characterized by difficulties with urination, the development of cystitis and infectious pathologies of the urinary system. In this case, the uterus has the correct position.
This is due to the non-retention of the musculo-ligamentous apparatus of the bladder and vagina. The urethra or bladder sinks to the front of the vagina, dropping it down to the genital slit.
In a critical situation, the bladder falls out with the vaginal wall completely outward. Basically, this type of prolapse accompanies women during menopause, as well as a high risk of its development in women with severe childbirth, which were accompanied by severe ruptures and injuries.
Currently there is a whole classification of these gynecological devices.
Supportive - created to support the uterus, preventing its omission. These include:
- gynecological pessary with an elevator, which is used in the treatment of incontinence,
- thin uterine rings,
- thick rings
- cup shaped
- made in the form of strips.
Filling - are intended to ensure that the walls of the uterus do not sag. They prevent the descent of the rectum and the bladder. This type includes:
- thick rings
- mushroom inflatable pessaries,
- cubic fixtures.
But, as in any method of treatment, the use of a pessary has its own contraindications. Doctors do not recommend installing a pessary in the following cases:
- with bleeding,
- in the presence of infectious diseases,
- in case of detection of inflammatory processes in the uterus,
- narrow passage of the vagina,
- as a result, the detection of precancerous diseases.
To install a gynecological pessary for permanent wear is not recommended for those who, due to certain circumstances, cannot visit a specialist every six months, as well as very loving women.
A pessary is a kind of ring that is made of high quality silicone or polypropylene.
- Supporting, it does not allow the vagina to sink, supports it.
- A thin ring fixed directly on the cervix.
- Thick ring.
- A bowl-shaped pessary with a special perforation is used to deduce the secretion of the sex glands.
- Cubic type of device.
- The filling ring prevents the process of prolapse of the uterus.
- Mushroom type.
Which type is better
The choice of the ring for the vagina should be made by the physician, the size, and also the form must fully comply with the anatomical features of the vagina, therefore only the attending physician is able to evaluate all these factors.
Supporting the type recommended to apply for prolapse of the second or third degree. The use of a ring-type device with strong prolapse can lead to a puncture of the uterus.
At the fourth degree of prolapse, it is better to use a cup-shaped type of device, with a levator it is used if the patient has, among other things, incontinence.
You should know that this device is different, some can be constantly worn, and some should be removed daily and carry out the treatment of the genitals.
It is very difficult to master the proper use and introduction of this device on your own, and if you have no experience, it is recommended to visit your doctor as often as possible, who will clean the genital tract himself.
In general, the use of this method of treatment is considered convenient and safe, with it women can lead a full life. Due to its unsurpassed versatility, this method of therapy solves many problems in gynecological terms in women.
Reviews of women who used the uterine ring
Medicine offers two main therapeutic methods for eliminating prolapse of the pelvic organs:
Surgical intervention is indicated for expressed forms. It represents a variety of operations in which they use their own fabrics, as well as various synthetic nets.
Although operations are considered an effective option in this case, they are often fraught with complications and recurrence of the disease.
Conservative therapy excludes the use of any medications or recipes of traditional medicine, since there are no traditional and medical drugs to eliminate this cause.
With conservative treatment, it is recommended to change the way of life, that is, to reduce physical exertion, remove extra pounds, carry out preventive measures to eliminate constipation, etc.
Also an element of this treatment is a special physical culture, which helps to train the muscles of the pelvic floor. In addition, an integral part of the conservative method is the wearing of certain bandages and pessaries.
How is a gynecological pessary installed and removed during pregnancy?
There is no difficulty in installing the fixture. You can spend it not only in the hospital, but also on an outpatient basis.
Pregnant women tolerate this procedure very well. In cases where a woman has a very low or high sensitivity of the uterus, then doctors recommend an No-shpa pill an hour before the procedure.
All manipulation does not take much time and is carried out only on the empty bladder. The gynecological pessary itself is treated with a gel, and then introduced into the woman's vagina.
After installation, it is produced every three weeks in order to prevent infection.
The pessary is not installed if a pregnant woman has blood discharge in the second or third trimester. Installation is also contraindicated in the presence of various inflammatory processes.
The doctor removes the pessary at 36 weeks, but there are cases when this is done a little earlier.
The advantages of this method of treatment
As with any treatment, the use of devices has its advantages and disadvantages.
- Effective therapy of the disease.
- Prevents preterm labor and helps maintain pregnancy.
- With any degree of prolapse of the uterus, this device helps a lot and patient reviews confirm this.
- Does not cause allergies.
- Safe method.
- Excellent alternative to surgery.
- There are no risks of damage to the uterus.
- It is used as an additional treatment for prolapse.
- Causes an unpleasant feeling of discomfort.
- Bacterial vaginosis may develop, but this is not always the case.
- Allocations increase.
- Due to improper installation may fall out.
Omission and prolapse of the uterus - what is it?
The prolapse of the uterus in women occurs due to the loss of the pelvic muscles and abdominal muscles of the usual elasticity and elasticity. This is a serious disease, a symptom of which is the exit of the body of the uterus beyond the vagina. The risk group in old age and the occurrence of this pathology include women who have previously had multiple or multiple normal pregnancies.
What is the uterine ring (pessary)
Gynecological or uterine rings (pessary when the uterus is descending) make it possible to keep the body of the uterus in its natural place. Silicone or latex devices are inserted into the vagina by a doctor in a clinic setting. Due to the elastic and elastic structure, they fix the body in the right place and prevent its displacement. The material of manufacture has a number of undeniable advantages. It is safe and hypoallergenic. A medical device, as a rule, does not cause discomfort, contributes to the normalization of vital activity, does not interfere with the usual flow of life. The mobility of the uterine pessary is ensured by the flexibility of the material, so that, if it enters the vagina, it easily assumes the shape and position.
How to use
To pick up the device, for the first time install and remove the gynecological ring should the doctor or patient under his supervision. The main task of the pessary is to keep the uterus in the correct position. In this regard, there should be no discomfort and inconvenience when worn. Stages of the procedure:
- since the rings are non-sterile, before using it is necessary to thoroughly wash the product with soap and water. This is done before and after each use.
- in order to prevent injury and to avoid internal damage, it is necessary to lubricate the device with special compounds that facilitate sliding,
- before entering the means, the changed body is returned to the natural position. The patient is in a gynecological chair, in cases where the procedure is performed in the clinic and lying on his back at home,
- ring in a compressed state is inserted into the vagina. Unclenched it inside. It is important that the device does not crash, but rather tightly touch the cervix. Only after performing all the actions, you can rise.
Before purchasing rings in case of prolapse of the uterus, it is possible, along with the characteristics and properties of the device, to monitor the prices of various sellers. The device can be bought in pharmacies, where the cost varies, depending on its type, material, size, and costs from 15 to 100.e.
No need to save on your own health. By purchasing a pessary, you will get rid of the discomfort that has plagued you for a long time, improve the quality of your life, and in some cases, completely get rid of years of developing problems.
How is the procedure
Omission or prolapse of the body of the uterus - the pathology is characteristic of patients over 45 years of age who have suffered multiple births. The cause of the development of the disease is the weakening of the muscles of the anterior abdominal wall and the small pelvis.
- Narrow entrance to the vagina.
- Uterine bleeding, the cause of which is not established.
- Infectious pathology.
- Inflammatory diseases.
- Precancerous cervical pathology.
contraindications associated with the development of infectious and inflammatory processes, bleeding quite easily can be eliminated and in the future install the uterine ring.
Permanent uterine ring is not established for patients who cannot regularly visit a specialist (every three months), and for women who have an active intimate life and do not have a pessary injection algorithm.
Before the introduction of the uterine ring must be tested for infections. Then the device and genitals are disinfected. As a disinfectant, use special ointment containing estriol, approved in gynecology. The ointment has a complex effect:
- facilitates the introduction of the device,
- activates blood circulation in the vagina,
- normalizes regenerative processes in a woman’s body,
- prevents the development of infections.
The gynecologist performs the following manipulations:
- the patient is on a gynecological chair or on a couch in the supine position,
- the doctor returns the organs to the correct position
- pessary is inserted into the vagina in a compressed form,
- The device is placed in such a way that the cervix is in the center of the pessary.
The procedure lasts one to two minutes and does not cause pain. After the introduction of the pessary
The gynecologist must ensure that the device is installed correctly and does not cause discomfort.
The ring should not fall out during straining. If the listed symptoms are observed, it means that it is necessary to choose a pessary of a different size or shape.
The first insertion and removal of the device should be carried out exclusively in the gynecological office, under the supervision of a physician. Then, over the course of a month and a half, a woman must visit a specialist once a week for routine inspection and treatment of the pessary and genitals.
The device is recognized as safe, after the introduction does not interfere with the normal life of the patient. This is an effective method for the treatment of prolapse, but in the case of non-compliance with the recommendations, there may be a risk of inflammation of the urinary canal and vaginal walls.
To avoid such troubles, the procedure is best carried out under the supervision of an experienced, qualified gynecologist.
The first installation is certainly a gynecologist in the clinic. Then the woman herself must learn to install it.
Before this, it is necessary to undergo a full examination for possible detection of inflammatory processes or infectious diseases. Before the introduction of this item, it is sterilized or rinsed in boiling water.
Для более легкого введения обычно используют вазелин.
The device is inserted in a horizontal position, during this process it is compressed and placed as far as possible into the vagina so that the convex part is turned to the cervix.
With this manipulation, if the patient correctly picked up and installed the ring, the woman should not feel pain or discomfort.
Naturally, everything needs to get used to and at first there will be a feeling of a foreign object in the body, but then the girl will not remember this element at all.
After installing this item, the girl should visit the gynecologist every two weeks for two months. This is necessary in order to ensure that the doctor is in the normal position of this device and that does not lead to other complications.
The average life of the ring is about six months, but it all depends on the stage of prolapse. If the device is not intended for permanent use, it is necessary to treat it with an antiseptic before each introduction into the vagina, this is very important.
One way or another, but if you have such a disease as prolapse, you should definitely try the rings first, and then if they don’t help you, then we recommend surgery.
In any case, this disease can not be left without attention. Reviews of patients using this method of treatment suggests that the treatment gives excellent results.
If you do not deal with this problem, it can lead to other irreparable consequences, therefore it is recommended to undergo therapy in a timely manner, to be tested.
And if there is an opportunity, then every six months, take tests and visit a gynecologist to identify the disease at an early stage and prevent its further development.
Every woman should give birth, and with a disease like prolapse, the chances of pregnancy are reduced to zero. Doctors around the world claim that this method of therapy can increase the chances of being able to safely carry and give birth to a child.
If you install a uterine ring at home
To facilitate the procedure, one leg can be put on a chair, bed or sofa. The pessary insertion algorithm is similar to the introduction of a tampon on menstruation days. To remove the ring, you need to squeeze the device with your fingers and gently pull it out in a compressed form.
If you use the uterine ring at home, you must regularly visit a gynecologist, undergo a qualified examination. Only a doctor is able to determine the effectiveness of using a pessary, as well as the duration of therapy.
Indications for installing the uterine ring
When the pathology is diagnosed in young patients, the most effective method of treatment is surgery. In old age, surgery is not always acceptable. Doctors attribute this to a number of reasons:
- more natural aging of the body
- the presence of chronic diseases.
With the advent of modern technology, the use of innovative materials, this technique becomes popular.
Installation of the uterine ring is assigned in the following pathological situations:
- omission and prolapse of the body of the uterus and vagina at the same time,
- urinary incontinence,
- contraindications to surgical methods of therapy,
- the presence of concomitant pathologies, gynecological diseases, which are treated before surgery,
- refusal of the patient from surgery,
- the need to predict the results of the operational method of treatment - the introduction of a pessary will help demonstrate the effectiveness and possible consequences,
- to detect urinary incontinence, burdened with prolapse,
- cervical insufficiency during gestation, which provokes the opening of the cervix and the cervical canal - this situation threatens the life of a child.
Essence of therapy
Uterine rings are now widely used to treat uterine prolapse. They are installed in the vaginal canal and serve as a mechanical support for the reproductive organ. In the early stages of omission, along with other therapeutic manipulations, these products help to achieve great results and complete recovery. With the prolapse of the uterus, the pessaries will not help to recover, but they are the best way to maintain the organ in the desired anatomical position, so that the patient can lead a more active life, cope with everyday needs, etc.
Indications for use of uterine rings in case of prolapse of the uterus are as follows:
- Persistent rejection of the operation.
- To improve the condition in the preoperative period.
- For relief after surgery.
- With decompensated diseases of internal organs, in which the operation is contraindicated.
Often uterine rings are used in elderly and debilitated women. Such therapy can be used for a long time and successfully help. But in advanced cases, unfortunately, it happens that with the help of pessaries the lowered uterus cannot be fixed.
Types of uterine rings
Morphologically, the reproductive system of a woman has structural features. This necessitates the individual selection of suitable uterine rings. In this regard, medical companies produce silicone products of various sizes and shapes. There are:
- Thin and fat pessary. With the prolapse of the uterus almost never used, effectively help with a slight displacement of the body.
- Bowl Ring. Happens two types: with an opening for removal of allocations and without it.
- Cubic type. It has characteristic concave sides, often used in case of prolapse of the uterus.
- Urethral It has a special structure, due to which joint retention of the urethra occurs.
- Mushroom Uterine Pessary. It has a characteristic mushroom shape, from which it got its name.
- Uterine Hodge Ring. The most convenient type, since the special material of the product takes the form corresponding to the structures of the genital tract - this makes the use of the pessary imperceptible.
Rules and recommendations for use
Procedures for the selection and installation of the uterine ring should be performed by a qualified technician. In the future, the patient performs periodic extraction and self-installation, so the doctor must train the woman in these manipulations. Periodically it is recommended to visit an obstetrician-gynecologist, so that he watches the course of the disease and is able to track the correct installation of the product.
Any uterine ring, regardless of the manufacturer, shape and size, is available in non-sterile packaging, which means that the product must be processed before use. Any chemical disinfectants used in medicine will do. Washing with soap and water, and then subsequent processing on the same principles should be carried out in the intervals between the extraction and subsequent installation of the ring.
Before you install the ring, you must return the uterus to the position that it should occupy in the norm. The woman is in a horizontal position, and the doctor performs reposition of the body. In the same pose, the installation of the supporting product is performed.
The method of administering the pessary is simple and any woman can handle it, even an advanced age. Immediately prior to installation, the ring should be lubricated with a gel, ointment or other liquid used in obstetric-gynecological practice to reduce friction in order to reduce the risk of injury to tissues to zero. Before placing the uterine ring in the vaginal canal, it is compressed (the product is made of flexible silicone and is easy to give). In this form, the pessary is placed at the cervix. When removing it, you also need to grab and squeeze, and then get it out of the vagina.
Kinds of pessaries
A gynecological pessary is a device, the introduction of which contributes to keeping the uterus in the correct position. For the manufacture of rings used materials such as latex, silicone, characterized by high quality and hypoallergenic.
There are several varieties of gynecological pessaries on the pharmaceutical market, each of which has its own characteristics and is used in different clinical cases:
- Urethral - like a ring that has a thickening from the outside. Promote simultaneous fixation of the urethra and uterus.
- Mushroom - resemble a ring that has a leg. Used in extreme cases when other devices do not have the desired effect. The maximum wearing time is no more than a day.
- Cup - have a characteristic bowl shape with a hole in the center. Shown for use in case of omission of the uterus in the initial or middle stage.
- Cubic - resemble a cube with walls bent inward. Equipped with special holes that deduce discharge, this type is used in the most severe and neglected clinical cases and has a limited duration of use.
- Urethral pancreatic - have the properties of the pan and urethral gynecological pessaries. Recommended for mild and moderate uterine prolapse with concomitant urinary incontinence.
- Hoxha Ring - is used for patients with anatomical features, because of which the use of other rings delivers uncomfortable sensations. They are distinguished by irregular circumference, flexibility, elasticity, ability to accept various configurations.
In addition, the uterine rings can be thick and thin. The best option is selected depending on the characteristics of the clinical case. Of great importance is the size of the ring.
All types of pessaries have several sizes, and it is almost impossible to calculate the required by yourself. The required form and dimensions should be detected exclusively by the attending physician individually, after a preliminary diagnosis.
In cases of uterine prolapse with first or second degree, the use of a supporting uterine ring is recommended.
Special obstetric rings are shown to pregnant women. In case of problems with urination, uterine rings are recommended, equipped with a special levator. If the pathological process has reached the third or fourth degree, the best option would be a cup-shaped gynecological pessary.
How to install gynecological ring?
Uterine rings must be able to enter independently, because the device is used at home. The first time the procedure is carried out in the clinic under the supervision of a specialist. Some types of pessaries are entered by the gynecologist 1 time and do not require extraction and re-installation.
The introduction of the ring is divided into several stages:
- Disinfection and thorough washing of the pessary with soap and water.
- Processing the device with a special vaginal cream or lubricant for easier and more comfortable installation, preventing injury to the mucous membranes and skin.
- The pessary is clamped in the hand, then introduced into the vaginal area, and then straightened so that it comes into contact with the neck and does not exert pressure on it.
The duration of use of a gynecological pessary depends on its form, the existing diseases and the individual characteristics of the patient. Most of the uterine rings (with the exception of mushroom and cubic) are allowed to use for a sufficiently long time period - 1-1.5 months. After 1.5-2 weeks, the woman should come to a specialist to undergo a pelvic examination.
The next visit to the gynecologist is carried out according to the plan in a month, then - once for 3 months.
Different uterine rings are used in various ways. Some types of pessaries are suitable for constant wear, requiring regular visits to the gynecologist. A number of models are used exclusively for physical exertion. Most models of uterine rings involves daily use. In this case, the device must be removed every day, processed using antiseptics and entered back.
Advantages and disadvantages of the method
Uterine gynecological devices are characterized by the presence of the following advantages:
- The possibility of fixing the uterus and urethra in cases where the operation is contraindicated.
- Simple and convenient operation in the case of properly selected shape and size of the gynecological pessary.
- High performance indicators at various stages of the pathological process.
- The minimum range of contraindications and possible side effects.
- No risk of traumatic injury to the genitals.
The method has some minor drawbacks, it is required to single out the following factors:
- Possible development of inflammatory processes.
- Problems in intimate life.
- Possible enhancement of uterine and vaginal discharge.
In addition, some women experience psychological discomfort caused by staying in the vagina of a foreign body.