Content

Uterine prolapse is a fairly common disease, appearing most often in women aged 45-50 years. It occurs due to muscle weakness abdominal wall and the small pelvis, which are involved in maintaining the uterus and appendages. Omission can occur due to numerous infectious inflammation, severe and multiple births.

To resolve this issue, medical practice wide application received specialized gynecological rings or pessaries.

Characteristics and types of gynecological rings

A gynecological ring is a device inserted into the vaginal cavity. It creates a kind of support and support for the normal position of the uterus. Most often, rings are made of silicone or latex. It is these materials that provide high elasticity, strength and safety of pessaries.

In addition to gynecological rings, there are obstetric rings. They are intended to prevent premature birth and prevent the development of isthmic-cervical insufficiency. In addition, a distinction is made between vaginal and uterine rings. The former are used as a method of contraception, and the latter for the treatment and prevention of a number of diseases.

Rings used for uterine prolapse come in several types. First of all, they are classified according to their shape:

• thin;
• curved;
• cup - used in the initial and middle stages of prolapse, have a hole for the release of secretions;
• cubic - used in severe stages of pathology, and can be used for no more than 12 hours;
• mushroom-shaped - rarely used and only for severe forms uterine prolapse;
• tandem - consist of two silicone elements, designed to eliminate 3-4 degrees of prolapse;
• calyceal-urethral - indicated for mild stage prolapse accompanied by urinary incontinence.

Depending on the individual characteristics and size of the vaginal cavity and the doctor selects the most suitable diameter of the device. Minimum size is 50 mm, and the maximum is 100 mm.

The advantages of these devices include:

• visible effect: gradually the uterus returns to its normal position;
• allow you to maintain pregnancy;
• prevent premature birth;
• do not cause allergies;
• quite simple and easy to use;
• do not interfere with the usual way of life;
• do not injure the walls of the vagina and cervix.

Despite all the above advantages, the pessary, if used incorrectly, can cause discomfort in a woman, lead to the development of bacterial vaginosis, and also compress the organs of the genitourinary system.

The gynecological ring, or pessary, has great value in the treatment of uterine prolapse. In this condition, the body becomes very vulnerable to pathogens and viruses, and displacement of the urethra can occur, leading to urinary incontinence. Prolapse of the uterus leads to poor circulation, which will affect the condition of all pelvic organs. That is why, to prevent all these problems, gynecologists prescribe the installation of a pessary.

Contraindications and indications

The main indications for installing a gynecological ring, in addition to uterine prolapse, are:

• organ prevention reproductive system before surgery;
• urinary incontinence due to urethral displacement;
• monitoring the results of the operation;
• maintaining pregnancy;
• preventing premature birth;
• impossibility or refusal to carry out surgical intervention.

The disadvantages of using a ring for uterine prolapse include individual intolerance and an allergic reaction to the latex or silicone from which the pessary is made. Restrictions also include:

• congenital pathologies or abnormalities of the reproductive system;
• cervical erosion;
• inflammatory processes;
• heavy bleeding;
• inflammation caused by infection;
• cervical neoplasms of various types.

Prescribe the installation of a gynecological ring, as well as select the right size Only a doctor should determine the type and diameter of this device.

Installation of a pessary

Correct installation of the gynecological ring during uterine prolapse ensures the absence of any discomfort in everyday life and during physical activity. That is why the first introduction of this device should only occur by a doctor.

There are stages of installation of a gynecological ring that prevents uterine prolapse.

1. Before directly inserting the pessary into the vagina, the device must be thoroughly washed with soap if it is not in its sterile original packaging. The product is then sterilized.
2. For easier and more convenient installation, it is recommended to lubricate the pessary with vaginal cream. This will make it easier for the ring to slide in.
3. It is necessary to return the uterus to its original normal position, which will subsequently be fixed by the gynecological ring. The first few times it is best to do this with a doctor.
4. If a woman has already received permission to put a ring on herself at home, then the following plan should be followed: take the ring in one hand, squeeze it and in this position insert it into the vaginal cavity. After it comes into contact with the cervix, it must be straightened. Make sure that the ring does not cause discomfort or pain, did not put pressure on the neck or bladder. This completes the installation of the pessary.

All types of rings, except mushroom and cubic, can be worn for 30-40 days. At first you need to go through gynecological examination every 1.5-2 weeks, then visit a doctor a month later. After the body gets used to it, consultation and examination are carried out every three months. This allows you to assess the condition of the mucous membranes and the position of organs in the pelvis.

Any discomfort, urinary incontinence or pain during physical activity should be accompanied by consultation with a gynecologist.

A gynecological ring is a fairly effective and safe device for eliminating uterine prolapse. It does not cause discomfort in everyday life, does not restrict a woman’s movement, and in most cases does not cause allergic reaction from the body.

Article outline

Age-related changes that occur in women in adulthood, as well as the presence of various gynecological diseases can contribute to a change in the position of the uterus, its descent down and movement towards the exit from the vagina, towards the natural passage and out. This is inconvenient and is fraught with the appearance of various infectious diseases. Good decision When the uterus prolapses, a uterine ring becomes present.

Prolapse and prolapse of the uterus - what is it?

Classification

Used in gynecology various types pessaries. They differ, depending on the diagnosed form of prolapse, individual anatomical features of the structure internal organs women, as well as with accompanying urinary problems.

There are several types of pessaries - ring and ring thick. This type used for mild and medium degree, has an internal elastic element that helps to effectively correct prolapse of the uterine body.

Cup and cup perforated pessary used for mild and moderate degree prolapse.

Urethral has a special device that supports the urethra. Used for urinary incontinence caused by uterine prolapse.

Urethral cup pessary used for mild to moderate prolapse. It is cup-shaped and helps support the urethra and prevent urinary incontinence.

Khoja Pessary– an elastic device helps in cases where it is not possible to use conventional means. It is used for severe forms of uterine prolapse, when identifying the anatomical features of a woman’s structure. Made in the form of a ring, inside of which there is an elastic reinforcement that allows you to change and give the required form designs.

Perforated cervical pessary made in the form of a deep bowl. It has a large main hole and small holes all around. The device helps to correct moderate uterine prolapse, and is also actively used as prophylactic to prevent childbirth early stages in women with short neck uterus

Cubic and cubic perforated pessary made in the shape of a cube, but without sharp corners. There are holes for drainage vaginal discharge. For convenient removal of the device from the vaginal cavity, a strong thread is provided. These models are used when severe degrees prolapse and are intended for use in short time(from 6 to 12 hours).

Mushroom-shaped pessary has a mushroom-like configuration. There is a thickening at the base of the leg. Designed for maximum deep insertion into the vagina. This type of device is used for a short time when it is not possible to use traditional forms. It installs on daytime and leaves for the night.

All designs have a size, which is very important and is selected individually. The parameters obtained as a result of clinical calculations of vaginal capacity are taken into account. This is done using special fitting rings. Self-determination of size is fraught with consequences that promise ineffectiveness and futility in using this device.

Indications for use

You need to start using the ring for prolapse at initial phase diseases. An analysis is performed before the procedure. A smear is taken to check for various infections. There are cases when a doctor mandatory prescribes the use of the device. This:

• the patient's categorical refusal to undergo surgery;
• the need to conduct a preliminary procedure before surgery;
• significant prolapse or prolapse of the uterus;
• the appearance of urinary incontinence;
• need for analysis after operations;
• an ideal way to maintain pregnancy.

Contraindications

Despite the excellent characteristics and significant assistance to a woman, uterine rings have some contraindications. They are not recommended for:

• pathologies of development of the genital organs;
• cervical erosion;
• colpitis;
• inflammation of the cervix;
• various formations in the pelvis;
• bleeding with unknown causes;
• acute infectious diseases.

When using the product, side effects may occur. As a result, inflammation of the urinary canal or vaginal walls at the points of contact may occur.

How to use it correctly

The doctor or the patient under his supervision must select the device, install and remove the gynecological ring for the first time. The main task of the pessary is to keep the uterus in the correct position. In this regard, there should be no discomfort or inconvenience when wearing. Stages of the procedure:

• Since the rings are non-sterile, you must thoroughly wash the product with soap before use. This is done before and after each use;
• to prevent injury and avoid internal damage it is necessary to lubricate the device with special compounds that facilitate sliding;
• Before administering the drug, the organ that has changed its position is returned to its 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;
• the compressed ring is inserted into the vagina. It opens up inside. It is important that the device does not cut into, but tightly touches the cervix. Only after completing all the actions can you rise.

All pregnant women want the pregnancy to go well, and then they give birth to a healthy, strong baby. However, not all expectant mothers succeed in this. Some people are prescribed a pessary during pregnancy, and women are scared, not knowing what this remedy is. An obstetric pessary is a ring-shaped device with which the uterus is fixed during pregnancy. Find out about the consequences of using a pessary, side effects and contraindications for its use will be of interest to any expectant mother who has been prescribed this device.

What is an obstetric pessary

Doctors call a small ring for pregnant women on the cervix a pessary. The most common device really looks like a ring, but there are a lot of variations in the shape of this instrument - there are obstetric cup-shaped, cubic, cone-shaped, mushroom-shaped devices that perform the same function - reliable fixation of the uterus so that the fetal pressure is distributed evenly over it. An alternative to installing the device is suturing the cervix, which can lead to negative consequences.

In what cases is it installed

A terrible diagnosis - “threat of premature miscarriage” - is heard today by every fifth pregnant woman during an obstetric examination. However, not everyone gets a special ring that will protect against spontaneous early birth and miscarriage expectant mother. Installation of an obstetric pessary is prescribed for isthmic-cervical insufficiency. This pathology is different the following signs:

• too soft and weak walls of the uterus;
• constant opening of the uterine pharynx due to its damage;
• short cervix.

This condition occurs after suffering gynecological diseases, abortions, constant curettage, difficult previous births, may be a consequence of diseases of the internal organs, or have a congenital form. Insufficient functioning of the uterus can lead to the fact that the membranes begin to penetrate the pharynx as the fetus grows, which can lead to infection, early rupture, and miscarriage. The use of a pessary in 85% of cases of obstetric practice helps to safely carry the fetus to term.

Types of obstetric pessaries

Each woman is individual, has her own dimensions of the vagina and cervix. Depending on these indicators, the following options for obstetric pessaries are distinguished:

• 1 type. Used during the first pregnancy, when the diameter of the cervix is ​​no more than 30 mm, and the length of the upper third part of the vagina is 60-65 mm.
• 2nd view. The use of such obstetric rings is justified during the second or third pregnancy, when the upper third part of the vagina is 65-75 mm, and the diameter of the cervix is ​​30 mm.
• 3rd view. Such rings are relevant for women who are carrying more than one child, whose upper third of the vagina is more than 76 mm, and whose cervical diameter exceeds 37 mm.

Until when should a pessary be inserted?

Diagnosis of the functioning of the uterus, its possible weakness and insufficiency of work - all this is done by obstetricians at the end of the first trimester. However, sometimes at these times it is not possible to establish the presence of pathology, and the final diagnosis confirming isthmic-cervical insufficiency is made in the second trimester. The pessary is installed between the 1st and 2nd trimester, at 13-23 weeks of gestation. The expectant mother should be prepared to wear this obstetric device for a long time, almost the entire period of bearing the baby.

How to choose

Correct selection obstetric pessary is very important, because this instrument helps save the life of the fetus and relieves pressure on the uterus, so you cannot try to choose the right device yourself. The need for installation should be recommended by a qualified gynecologist or obstetrician, based on the data ultrasound examination and visual examination of the uterus, during which its diameter and vaginal dimensions are determined.

The material for the manufacture of this obstetric instrument is silicone or special soft plastic. A gynecologist helps a pregnant woman choose the required product, pointing out the specific manufacturer, type and type. It was noted that when using imported pessaries, there is less side effects, and these devices are better tolerated by the body.

How to place a pessary

Before placing the ring, you have to take smears to check the vaginal microflora. Besides this, necessary indications to the installation of this obstetric device is the normal tone of the uterus and the absence of protrusion membranes in the pharynx, the diameter of the cervix is ​​not less than 30 mm, and the upper third part of the vagina is not less than 60 mm. Obstetricians claim that the ring installation procedure is atraumatic and painless, however, if you have low pain threshold, then you can ask to apply local anesthesia. The pre-selected structure is installed as follows:

• The woman lies on her back with her legs spread wide.
• The gynecologist generously lubricates the obstetric pessary with a special cream or gel and begins to insert it into the vagina with a wide base.
• After insertion, the ring is unfolded so that the base is deep in the vagina, and narrow part- under pubic bones pelvis Installation takes 15-20 minutes, after which you can get up and go home.

Do's and don'ts after inserting a pessary

You should not think that all problems are over after installing the obstetric ring, and you can relax without visiting doctors. In order for the embryo to develop normally, certain medical requirements must be observed when installing a pessary:

• Vaginal intercourse should be stopped.
• Heavy ones should be avoided physical activity, try not to bend over or squat.
• See a gynecologist at least 2 times a month so that the doctor, during the examination, makes sure that the device is in place and has not moved anywhere.
• You will have to regularly take a smear to check the health of the microflora, since wearing an obstetric ring can provoke the occurrence of vaginal infections, which are treated on an outpatient basis.
• Under no circumstances should you try to remove the pessary yourself.

Possible complications while wearing

Since the device is foreign body, introduced into the body at long period, possible the following complications when wearing an obstetric pessary:

• Constant discharge from the vagina. If this is not leakage of amniotic fluid (to rule out this option, buy the appropriate test at the pharmacy), and the discharge is clear and odorless, then you can calm down - everything is going fine.
• The occurrence of candidiasis and other fungal diseases.
• Inflammation of the walls of the vagina and cervix, colpitis, vaginitis.

Discharge after installation of a pessary

Immediately after installation, you can find the device in your home spotting brownish color. Normally, they should be scanty and stop 3-4 days after installing the pessary. However, if the discharge becomes more and more abundant, you should consult a doctor. Greenish discharge, as well as itching and burning of the vagina indicate the development of a fungal or bacterial infection. This situation should also be the reason for an unscheduled visit to the gynecologist.

What does it feel like if the pessary has moved?

If the device is installed correctly, the woman should not feel any discomfort. However, if when changing position, bending, changing position, she feels discomfort and inconvenience in the uterine area, then there is a possibility that the device does not occupy the desired position. This may be evidenced by simultaneous copious discharge whitish tint. If such symptoms occur, you should immediately consult a doctor so that he can correct the position of the instrument and return it to its place.

When to remove the pessary

In a normal pregnancy, the obstetric device is removed around 38 weeks, before the woman is about to give birth. If cervical edema is diagnosed, then extraction may be accompanied by painful sensations. Early withdrawal instruments are produced in a hospital under such circumstances.

How effective is a pessary for uterine prolapse? Patient reviews indicate that this device can solve complex problems with health. To date, there is no treatment for prolapse as such; only surgery can help with this disease. Doctors from all countries unanimously claim that a patient diagnosed with prolapse can only be saved by surgical intervention. Finding Other Options treatment is underway constantly, if earlier such an operation threatened to traumatize soft tissues, today medicine has gone far ahead, it has become more technologically advanced and of higher quality. A ring for uterine prolapse is a real salvation if a woman does not want to resort to a radical method - surgery.

A pessary will replace surgery

The surgical method for uterine prolapse is the most the best option therapy for young girls. For older ladies, this method is not entirely suitable, since the operation may be impossible due to other diseases; often women of Balzac’s age do not dare to resort to surgical intervention and choose conservative species therapy for prolapse.

Today, the pessary is an innovative invention in the treatment of prolapse.

When can I install?

• Urinary incontinence, uterine problems, in the absence of other pathologies.
• Reluctance to undergo surgery.
• When can uterine defects be cured without surgery?
• When you need to see the results of an operation, in this case a pessary allows you to adequately assess the effectiveness of treatment.
• When diagnosing urinary incontinence.

When not to install a pessary

1. Uterine cancer or precancerous condition.
2. Uterine bleeding.
3. Infection of the genital organs.
4. Inflammatory process.

Ladies who have a vigorous sexual life are also not recommended to use a pessary if they cannot install it correctly on their own. If it is not worn all the time, the result of such treatment will not bear fruit, since it must be used constantly.

What is a pessary and what types of it exist?

A pessary is a kind of ring that is made of high-quality silicone or polypropylene.
The shapes and sizes of this device are very diverse, so choosing it will not be difficult. Here are the most basic forms and its types:

1. Supportive, it does not allow the vagina to sag, it supports it.
2. A thin ring is fixed directly on the cervix.
3. Thick ring.
4. A cup-shaped pessary with a special perforation is used to remove the secretion of the gonads.
5. Cubic device type.
6. The filling ring prevents the process of uterine prolapse.
7. Mushroom type.

Which type is better

The choice of a ring for the vagina should be made by a physician; the size and shape must fully correspond to the anatomical features of the vagina, so only the attending physician can evaluate all these factors.

For the fourth degree of prolapse, it is better to use a cup-shaped device; it is used with a levator if the patient, among other things, also has urinary incontinence.

You should know that this device varies, some can be worn constantly, and some should be taken out daily and the genitals treated. Master correct use and introducing this device yourself is very difficult, and if you do not have experience, it is recommended to visit your doctor as often as possible, who will clear the genital tract himself. In general, the use of this method of treatment is considered convenient and safe; women can full life. Thanks to its unrivaled versatility, this method therapy solves many gynecological problems in women.

Advantages of this treatment method

Like any treatment, using a device has its pros and cons.

Pros

• Effective therapy of the disease.
• Prevents premature birth and helps maintain pregnancy.
• For any degree of uterine prolapse, this device helps a lot, and patient reviews confirm this.
• Does not cause allergies.
• Safe method.
• An excellent alternative to surgery.
• There is absolutely no risk of damage to the uterine cavity.

Cons

• Used as additional treatment prolapse.
• Causes an unpleasant feeling of discomfort.
• May develop bacterial vaginosis, but this does not always happen.
• The discharge increases.
• It may fall out due to improper installation.

How does the procedure work?

The first installation is carried out by a gynecologist in an outpatient clinic. Then the woman must learn how to install it herself. Before this you need to go through full examination for possible detection inflammatory processes or infectious diseases. Before introducing this item, it is sterilized or rinsed in boiling water. For more easy administration Vaseline is usually used.

The device is inserted in a horizontal position, during this process it is compressed and installed as deep as possible in the vagina so that the convex part is turned towards the cervix.

During this manipulation, if the ring is correctly selected and installed for the patient, the woman should not feel pain or discomfort.

Naturally, you need to get used to everything and at first there will be a feeling foreign object in the body, but then the girl will not remember this element at all.

After installing this element, the girl must visit a gynecologist every two weeks for two months. This is necessary so that the doctor makes sure that this device is in a normal position and that it will not lead to other complications. Average term Using the ring is approximately six months, but it all depends on the stage of prolapse. If the device is not intended for permanent use, then it must be treated with an antiseptic before each insertion into the vagina, this is very important!

One way or another, if you have a disease such as prolapse, you should definitely try the rings first, and then if they do not help you, then it is recommended to have surgery. In any case, such a disease cannot be ignored. Reviews from patients using this method therapy indicates that the treatment gives excellent results.

If this problem is not dealt with, it can lead to other irreparable consequences, so it is recommended to undergo timely therapy and tests.

And if possible, then get tested every six months and visit a gynecologist to early stage identify the disease and prevent its further development. Every woman must give birth, and with a disease such as 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.