Pessary during pregnancy: how and why it is placed, which one is better. Pessary during pregnancy. Obstetric pessary: ​​setting and wearing How to select the size of a pessary

If a woman is diagnosed with uterine prolapse, then all possible measures are immediately taken to prevent its loss. As a rule, if such a problem occurs, doctors recommend taking the following steps: wearing a bandage, doing exercises that will help strengthen the pelvic muscles, and adhering to the principles of proper nutrition. However, none of these measures can compare in effectiveness with the installation of a pessary. But women quite often wonder: can a pessary fall out?

A pessary (uterine ring) is a supporting implant that secures the uterus, preventing it from falling out. These medical devices are made of latex or silicone. This choice of materials is due to the fact that they are elastic, harmless and do not cause allergic reactions.

Who should have a pessary installed?

• The woman categorically refuses to undergo the operation.
• The patient consented to surgical intervention, but before the procedure it is necessary to treat existing diseases of the genital organs.
• Prolapse or prolapse of the uterine cavity.
• Hidden enuresis was revealed.
• It is necessary to maintain the pregnancy.

Contraindications for installing a pessary

A pessary for uterine prolapse is contraindicated in the following cases:

1. The woman is allergic to the materials from which the pessary is made.
2. There are deviations in the development of the reproductive organs.
3. The inflammatory process (vaginitis), caused by infections, injuries and disruptions in endocrine and metabolic processes, progresses in the vagina.
4. Bleeding for unknown reasons.
5. Inflammation of the uterine cervix.
6. Tumors in the pelvic area.
7. Infectious diseases occurring in acute form.
8. Erosion of the uterine cervix.

Side effects

When installing a pessary, there is a possibility of developing an inflammatory process in the urinary canal, since the diaphragm puts pressure on it. Besides, possible inflammation of the vaginal walls at those points where the ring comes into contact with the mucous membrane.

Types of pessaries

The variety of shapes and sizes of this product will allow you to find a suitable option for any woman. Uterine rings come in the following types:

• Supportive.
• The ring is thin and thick.
• Cup-shaped. It has special holes designed to remove various secretions.
• Cubic.
• Fillable.
• Mushroom-shaped.

What type of pessary do you prefer?

The health worker should select the optimal shape and size of the gynecological ring, since these parameters should best suit the anatomical features of the vagina. Only a doctor can correctly assess these criteria.

A supporting type of pessary is suitable for prolapse of the second or third stage. The use of a ring-type product can cause compression of the uterus if a woman has heavy discharge.

When the prolapse has already reached the fourth stage, it is preferable to use a cup-shaped pessary. If a woman also has urinary incontinence, then a levator ring is necessary.

How is a pessary installed?

A ring for uterine prolapse (pessary) is attached to the uterine cervix. This product fixes the uterus in the correct position, preventing it from descending. As a rule, the ring is suitable for women of advanced age or at an early stage of pathology. How is a gynecological ring installed? This procedure must be performed by a doctor. Before installing the product, a smear is taken from the woman, which is necessary to identify possible infections.

The ring is inserted in a lying position with the legs bent at the knees. After installing the implant, the woman should stand up and evaluate her sensations. If the ring is installed well, there should be no pain. You need to visit your gynecologist every two weeks for one and a half months after the insertion of the uterine ring. In order to clean the product, it must be removed and wiped with a special disinfectant.

Is it possible for a pessary to fall out?

If the pessary is inserted normally, it will be almost imperceptible. Accordingly, a woman will not feel any discomfort when wearing it. As a rule, the patient quickly gets used to the fact that she has this implant installed in her vagina and stops noticing it. But any woman experiences anxiety, fearing that the ring may fall out, especially if it was installed during pregnancy.

Of course, there is a possibility of such a problem occurring, but it is extremely small. The reason for a pessary falling out may be an incorrectly selected type or size, as well as its poor-quality installation. If the ring has moved from the right place, the woman will certainly feel it, since the product will begin to cause discomfort. First of all, it will be uncomfortable to sit, because the pessary will become felt when changing positions.

However, in situations where the uterine ring is selected in accordance with all the anatomical parameters of the woman, and she follows all medical recommendations and is careful in wearing it, then there is no need for unnecessary worries about its loss, since under such conditions this is simply impossible. In addition, sometimes a woman thinks that the ring is installed very low and can even be touched during hygiene procedures.

It is worth considering that if there is no unpleasant, painful or uncomfortable sensation, then there is no need to reach into the vagina to feel the pessary. You also need to regularly visit a doctor, who will check whether the ring is positioned normally.

Discharge when using a pessary

When a ring is installed when the uterus is prolapsed, vaginal discharge must be carefully monitored. If unexpected changes occur in the nature of the discharge, then immediate consultation with a doctor is necessary.

The presence of a small amount of bloody discharge or ichor immediately after insertion of the ring is considered normal and goes away quickly. But if they last for a long time, then you need to inform the doctor. In addition, it is necessary to pay attention to discharge that has a yellow or green tint, indicating the presence of a bacterial infection. It is also worth considering that while wearing the ring, the amount of discharge increases and this is considered normal.

In general, we can say that the pessary is an excellent alternative to surgery and a good way to maintain pregnancy. However, do not forget that in addition to installing the ring, you need to do special exercises and eat the right foods.

Such a nuisance as uterine prolapse can happen to every woman. This problem most often occurs in adulthood, and in most cases is explained by stretching of the pelvic floor muscles. Treatment for uterine prolapse depends on many factors: the severity of the disease, the individual characteristics of the patient and, of course, the presence or absence of concomitant disorders. Uterine rings are considered one of the correction options. Uterine rings help to cope with the problem in case of uterine prolapse. Let's talk on the www.site about how to insert the uterine ring, how often they need to be changed, and how such a device is disinfected.

Uterine rings are also known as pessaries. This is a special design that is designed for installation on the cervix. Such a device is designed to hold this organ in the desired position and prevent its further displacement. The pessary is made of special flexible silicone, and the insertion procedure is carried out by a doctor on an outpatient basis.

Uterine rings can have different sizes, depending on the degree of prolapse (or prolapse) of the uterus. Of course, the desired version of such a device should be selected exclusively by the doctor. When choosing the size of the uterine ring, the specialist focuses on the anatomical features of the patient. The initial selection of a pessary is carried out on a gynecological chair, and the patient’s bladder must be completely full. A ring of the smallest diameter is used, which can eliminate or reduce the manifestations of pathology. If the size is chosen correctly, then there should be a small gap of one centimeter between the pessary and the vaginal wall.

How often should I change the uterine ring?

With the initial degree of prolapse, the pessary may well be removed at night. In this case, the doctor teaches the patient to remove it independently and then install it. Sometimes the ring is advised to be used only in cases where the patient has to walk or exercise for a long time.

Disinfection of the uterine ring

Of course, before using the pessary, it is necessary to properly disinfect it. Such a device can be washed with ordinary warm water using detergents (ordinary soap) or without them at all. In medical institutions, aldehyde-containing solutions can be used for disinfection. Also, such a device can be sterilized with steam - 134C/3.8 bar or simply with hot air - 250C.

The uterine ring can be subjected to repeated disinfection. But the appearance of cuts or cracks on it is a contraindication to its further use. The pessary should only be stored at room temperature. Although this goes without saying, it must be emphasized that such a device is intended only for individual use.

Introduction of the pessary

Immediately after disinfection, the pessary should be lubricated with a small amount of ointment composition, which is approved for use in gynecological practice. Preference is given to ointments containing estriol. Such medications help greatly facilitate administration and improve local blood circulation. In addition, the ointment effectively activates regenerative processes and prevents the occurrence of infections.

Immediately before the introduction of such a device, the lowered organs must be returned to the anatomically correct position. This is done by the gynecologist during the initial installation of the pessary. The pessary is installed in the supine position - at home or on a gynecological chair.

The uterine ring is compressed and inserted directly into the vagina in a compressed form. Afterwards, the pessary must be turned towards the uterine cervix so that it is located inside the central hole. The wide base of such a device should face the entrance to the vagina.

Many patients find it convenient to insert the uterine ring in a different position: one leg should be placed on a table or on a stool (you can also use the edge of the bed). This is usually how tampons are inserted during menstruation.

To remove the pessary correctly, you should carefully grab it with your fingers and squeeze it a little. The product is removed from the vagina exclusively in a compressed form. Since silicone is characterized by excellent elastic qualities, the patient experiences virtually no discomfort when using it.

Even if a woman can insert and remove a pessary on her own, she still needs to be regularly monitored by a doctor. And the duration of use of such a device is determined only on an individual basis.

After the insertion of the uterine ring, the patient needs to make sure that she does not feel any unpleasant symptoms or have difficulty urinating. Also, the pessary should not fall out when straining. The appearance of the described negative symptoms is an indication for using a ring of a different size.

The first attempt to independently insert and remove a pessary should be carried out exclusively under the supervision of a gynecologist.

The uterine ring is believed to be a safe and comfortable device that will help many patients live a normal life.

The size of the ring (pessary) is determined by the outer diameter:

Portex Uterine Rings are made from thermoplastic, implantation-free, non-toxic polyvinyl chloride (under the influence of body temperature, the ring becomes softer, changes its shape, adapting to individual anatomical features, and this is maximum comfort for the patient).

The price is for 1 piece.

The advantage of uterine rings Compared to cup-shaped pessaries, the width of the walls is small. This design feature provides a smaller area of ​​contact with the vaginal mucosa and does not interfere with the outflow of secretions.

Portex Uterine Rings used for the conservative treatment of uterine prolapse and prolapse of the vaginal and uterine walls.
Uterine prolapse is a disease that occurs due to laxity of the anterior abdominal wall and pelvic floor. Uterine prolapse is often accompanied by prolapse of the vaginal walls, involving the walls of the bladder or rectum. There is a downward displacement of the uterus along the pelvic axis, which, as the disease develops, leads to the uterus extending beyond the genital slit - uterine prolapse, and the uterine rings support the cervix and prevent it from moving downwards.

The size is selected individually.
It must be determined by the attending gynecologist. The ring must be installed by a doctor.

Since constant wearing of the ring can lead to the development of a local inflammatory reaction, the formation of bedsores, erosions, fistulas and other complications, it must be periodically removed, treated and changed. In order to detect complications in a timely manner, it is necessary to periodically visit a doctor.
At first, use the ring at least once a week, then at least once every three months. The doctor must determine the time of the ring’s condition by assessing the condition of the vaginal mucosa and test results (vaginal smear).

The uterine ring (pessary) is supplied in non-sterile individual packaging.

​Correspondence between the sizes of Russian-made rings and Portex:

1. 62, 65, 68
2. 71, 74 77
3. 80 85

The online store of medical and health products “MedMag24” invites you to familiarize yourself with Portex Uterine Rings and purchase them at an attractive and best price!
You have questions? We will be happy to answer them and help you with your choice. Call and order!​

Or uterine prolapse is a fairly common pathology, which is most often diagnosed in older women, but this disease is also not uncommon in women of the reproductive period.

For a long time, prolapse may not be accompanied, and the woman may not even be aware of it.

But as the disease progresses, the symptoms intensify, causing the patient significant discomfort, and without treatment, the consequence of prolapse can be disability.

In this article we will look at one of the ways to combat prolapse - using a pessary or intrauterine ring.

The essence of pathology

The reproductive organ is held in the pelvic cavity by means of a ligamentous apparatus and a muscular corset. If the tone of the muscles and ligaments weakens, the organ begins to change its anatomical position, going lower.

The situation is aggravated by pressure on the uterus of 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 prolapse of the organ occurs insignificantly, the cervical region approaches the genital slit, but does not come out;
• - more significant prolapse, in which, when straining or coughing, the cervical area may extend beyond the vaginal limits;
• third degree- reproductive organ. The cervical region and part of the body of the uterus protrude beyond the vagina;
• fourth degree or – the uterus completely comes out of the vagina.

Despite the absence of a threat to a woman’s life, uterine prolapse can be fraught with various complications that can significantly worsen the patient’s quality of life, as well as lead to various associated ailments.

What is a pessary?

Simply put, a pessary (pisarium) is an elastic ring that is actively used in gynecological practice for various pathologies, including prolapse of the uterus.

The gynecological ring is made from biologically pure and safe materials. Most often it is silicone or a special plastic that has high plasticity. Such materials easily take the shape of a woman’s genitals, which means their use will not cause discomfort.

The pessary is sold sterile, but before purchasing the product, you must check the expiration date. All edges of the ring are smooth, they fit tightly around the cervix, keeping it from prolapse and preventing its dilatation.

The device has holes for vaginal discharge.

Why is it needed?

Of course, surgical treatment of prolapse (for example, when a mesh is installed) is the best option for solving the problem of uterine prolapse, but in most cases it is used in relatively young patients.

For older women, surgical intervention is prescribed much less frequently. This is due to various contraindications and underlying diseases of patients. At the same time, prolapse is most often diagnosed precisely after menopause, which is due to involutional processes occurring in a woman’s body.

Conservative methods do not always give a positive result, and then a pessary is the most effective alternative to prolapse.

Medical technologies do not stand still, and new materials and forms of pessaries are currently appearing, which makes this device increasingly popular and in demand.

An intrauterine ring or pessary is the only way for many women to lead an active and fulfilling lifestyle. But before deciding to install it, a woman should understand that pessaries are different - some need to be taken out and washed every day, while others can be worn constantly. Indwelling pessaries are recommended for older women as they may have difficulty re-inserting them themselves. In general, this device is convenient to use, safe, and most importantly, it solves the problem of complete loss of the reproductive organ. However, the pessary is not only intended for use by elderly patients; uterine prolapse can also occur in young women, and even when carrying a child, so the pessary can be considered a universal therapeutic device that can solve a large number of women’s gynecological problems.

Advantages and disadvantages

Among the advantages of the pessary are:

• partial compensation of prolapse;
• the ability to lead a full life without surgical intervention;
• ease of use and maintenance;
• safety and hypoallergenic;
• If the device is selected correctly, there is absolutely no risk of soft tissue injury.

However, there are also negative aspects of using a pessary:

• the volume of discharge may increase when wearing the ring;
• Possible difficulties during intimate contacts;
• impossibility of use in inflammatory processes of the pelvic organs. This is despite the fact that long-term wearing is indicated for elderly women whose mucous membranes naturally atrophy, 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 a uterine ring required?

Installation of a pessary is necessary in the following cases:

• uterine problems that are not accompanied by other pathologies;
• the patient’s inability or desire to undergo surgery;
• it is possible to cure existing gynecological defects without surgical intervention;
• it is necessary to evaluate the effect of the operation;
• when diagnosing urinary incontinence.

NOTE!

Before installation, you must take a vaginal smear to check for infections.

What types are there?

The main types of pessary are as follows:

• supportive – supports the vagina, preventing it from descending;
• thin - placed on the cervix;
• thick;
• cup-shaped - for removing the secretions of the gonads;
• cubic;
• filling – prevents uterine prolapse;
• mushroom.

The doctor decides which type is best to use individually in each specific case.

The photo below shows different types of these devices.

How does the installation work?

The initial installation of the uterine ring takes place in the gynecologist's office; in the future, the woman must learn to carry out this procedure on her own.

Before inserting 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 towards the cervix.

This procedure is carried out in a horizontal position. If the ring is selected and installed correctly, there should be no discomfort, let alone painful sensations.

After installing a pessary, a woman should visit a gynecologist every two weeks for two months so that he can monitor the process and make sure that the device does not lead to complications.

Usually the ring is placed for six months, but for older patients it is prescribed for life.

Contraindications

Not all cases allow the uterine ring to be inserted safely.

There are a number of contraindications that do not allow its use:

• precancerous condition of the uterus or cancer;
• bleeding;
• genital infections;
• the presence of an inflammatory process.

Also, installation of a uterine ring is not advisable for women who, for some reason, cannot come to see a gynecologist at least once every six months.

Women who are sexually active are allowed to use a uterine ring only if they know how to insert it correctly themselves.

Reviews from women

Below are reviews from women about using the uterine ring:

(( reviewsOverall )) / 5 Patient assessment (8 votes)

Evaluation of a drug or treatment