Pessary (gynecological Ring) For Prolapse Of The Uterus - Is It Effective?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Pessary for prolapse of the uterus

The prolapse of the uterus significantly reduces a woman's quality of life. Most often, the prolapse of this organ occurs in adulthood and old age. The pathology is characterized by physical discomfort, problems with urination and defecation. Sexual intercourse with prolapse of the uterus is unlikely or not possible at all. A gynecological pessary is used to return a woman to live and work fully, to partially solve the problems that have appeared along with the weakening of the muscles and ligaments of the uterus.

The gynecological ring is used in cases where surgery cannot be performed. Having decided to use a pessary, you need to remember that only an operation can finally relieve a woman from the prolapse of the pelvic organs.

Content:

• What is a pessary?
• Pros and cons of using gynecological pessaries
• How to use a pessary?
• Why is it necessary to use a pessary when the uterus prolapses?

What is a pessary?

A pessary, or gynecological ring, is a product made of elastic medical silicone or latex. This hypoallergenic, safe device is inserted by the doctor into the patient's vagina, easily takes the desired location, without affecting the woman's activity and habitual lifestyle.

The main function of the gynecological ring is to create support for the organ, preventing its displacement from the anatomically correct position. For each specific case of prolapse of the uterus, a certain type of pessary is selected, which differs from other rings in shape, size, diameter and type of purpose.

Types of pessaries:

• Urethral - has the shape of a ring with a thickening outward, is used to simultaneously fix the uterus and urethra;
• Cup, perforated cup - has the shape of a cup with a large hole or with perforation, it is used for the middle and initial level of uterine prolapse;
• Cup-urethral - combines the qualities and advantages of both previous types;
• Cubic, cubic perforated - has the shape of a cube with walls concave inward with a hole for the discharge of secretions, is used for severe prolapse, worn for a short time (8-12 hours);
• Mushroom - has the shape of a ring with a leg, it is used for severe prolapse of the uterus, the pessary is removed at night;
• Hodge pessary - used in special cases in women with anatomical features of the uterus and vagina, takes any shape;
• Thin and thick ring - used in the initial stage of prolapse.

Each type of pessary comes in several sizes. If the size of the gynecological ring that a woman needs is calculated incorrectly, she will not be able to use the device. Therefore, the selection of the pessary must be entrusted to the doctor. So, for example, if, with a strong prolapse of the organ, a ring-type device is used, the risk of pushing the uterus through the ring and its infringement increases.

A video that includes a description of the Juno obstetric unloading pessary and the method of its use:

Pros and cons of using gynecological pessaries

Advantages of the device:

• Uterine prolapse is partially compensated;
• You can do without surgery;
• Pessaries are easy to use and maintain;
• The devices are safe and hypoallergenic;
• With the correct selection of the gynecological ring, there is no risk of injury to the soft tissues of the pelvic organs.

Disadvantages that prevent the use of the pessary as directed:

• When wearing a gynecological ring, the volume of discharge from the cervical canal may increase;
• Difficulties may appear in the implementation of sexual intercourse;
• The pessary cannot be used for inflammation of the pelvic organs, although its wearing is required, first of all, for women of mature age, whose atrophied mucous membrane is extremely susceptible to the action of bacteria;
• The psychological barrier makes it difficult to transfer the presence of a foreign object into the vagina.

How to use a pessary?

The doctor will help you install the device the first time by performing this procedure on an outpatient basis. He will definitely introduce a woman to the rules for using pessaries, teach her self-administration. Before insertion, the gynecological ring is sterilized or rinsed in boiling water. To facilitate the introduction, you can use petroleum jelly, vaginal cream, vegetable oil.

To return the uterus to its usual position, lie on your back before inserting the pessary. The squeezed device is taken in the hand and inserted into the vagina until it touches the cervix. Very strong pressure on the cervix should be avoided. Then the woman can stand up.

All types of pessaries, except for the cuboid and mushroom-shaped device, can be worn for up to 30-40 days without interruption. After 10-14 days, the woman should consult a doctor to examine the vaginal mucosa and assess the appropriateness of using a pessary. A properly installed device does not cause discomfort, does not move when walking, defecating, urinating.

Video about the introduction of the pessary:

Why is it necessary to use a pessary when the uterus prolapses?

If the prolapse of the uterus is not compensated for, the following complications may occur:

• Development of colpitis, cervicitis, penetration of infection into the uterus and ovaries due to the gaping of the genital fissure and the low position of the cervix;
• Leakage of urine during stress, laughter, heavy lifting due to the prolapse of the anterior wall of the bladder;
• The development of cystitis, pyelonephritis due to problems with urination;
• Development of eczema and pyoderma due to skin irritation with urine;
• Infringement of the uterus and vaginal walls in the genital cleft, organ necrosis due to circulatory disorders;
• Inversion of the uterus.

To prevent complications of uterine prolapse, a gynecological pessary should be worn.

The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist

Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.