Consider the instructions for using uterine rings for prolapse of the uterus. This pathology in medical science is considered as a hernial protrusion, which is formed when the pelvic floor functions as a closing apparatus. According to the results of studies conducted in the field of gynecology, uterine prolapse accounts for approximately 30% of all gynecological pathologies. This disorder is also called uterine prolapse. It rarely occurs in isolation: the anatomical proximity and integrity of the supporting apparatus of the pelvic organs, following the genitals, causes the displacement of the bladder and rectum.
There is also an incomplete (partial) prolapse of the uterus, which is characterized by displacement of only the cervix, and complete prolapse, when the uterus is completely outside the genital slit. With this pathology, elongation (lengthening) of the neck develops. In most cases, the disease is preceded by omission of the organ - some displacementsrelative to the normal anatomical level in the pelvic cavity. Reviews of the uterine ring for uterine prolapse will be presented at the end of the article.
Causes of uterine prolapse
The key role in the development of this pathology belongs to the weakening of the muscles and ligaments of the diaphragm, anterior abdominal wall, pelvic floor, which lose the ability to hold the pelvic organs in a normal anatomical position. In situations of increased intra-abdominal pressure, the ligaments cannot provide the necessary resistance, which gradually leads to a downward displacement of the genital organs.
Weakening of the muscular and ligamentous apparatus develops as a result of birth injuries, multiple pregnancies, perineal ruptures, multiple births, radical interventions on the pelvic organs, the birth of large children. Uterine prolapse is also preceded by an age-related decrease in estrogen levels, a weakening of one's own uterine tone.
A pronounced load on the pelvic muscles develops with excess weight, in conditions that are accompanied by an increase in pressure inside the peritoneum (cough, chronic bronchitis, ascites, constipation, pelvic tumors, etc.). The cause of uterine prolapse is also hard physical labor. More often, the pathology occurs in old age, but it can develop even in young nulliparous women.
Description
The uterine silicone ring can be either rubber. It is inserted into the vagina to support the pelvic organs - uterus, rectum, bladder. Moreover, such devicesare used to prevent the progression of the pathological process, normalize the patient's well-being, relieve discomfort. In modern gynecology, this technique is also used for prolapse of the uterus, its shift towards the vagina, and also for prolapse. The uterine ring for uterine prolapse, according to reviews, is an effective way to prevent inflammatory complications.
Indications for use
Vaginal uterine rings are recommended for the following clinical indications and diseases of the female genital area:
- Prolapsed uterus.
- Movement of the uterus outside the vagina.
- Prolapse of the uterus, which is typical for women aged 45-50.
- Therapy of female genital organs before surgery.
- Presence of contraindications to operations on the genitals.
- The need to maintain pregnancy, including multiple pregnancy.
- Diagnosis of urinary incontinence, which occurs in a chronic form.
- Premature labor prevention.
- Displacement of the urethra, which is accompanied by urinary incontinence.
- Consolidation of the therapeutic result obtained during the surgical procedures.
- Prolapse of the uterus with urinary incontinence.
The uterine ring in case of uterine prolapse helps to cope with the pathology even at the most advanced, severe stage of the disease. Uterine pessaries help patients forget aboutpain and discomfort, lead a fulfilling life.
In pregnancy, the establishment of the uterine ring should be indicated if there are such clinical indications:
- Violation of the functional indicators of the ovaries, which occurs in severe forms.
- Isthmic-cervical insufficiency, which contributes to the softening of the cervix and its premature opening.
- History of spontaneous miscarriages, premature births, abortions.
As a prophylactic, the uterine pessary is recommended to be used after caesarean section, with excessive physical exertion.
Types of uterine pessaries
Gynecological pessary is a device, the introduction of which allows you to keep the uterus in the correct position. For the production of rings, materials such as silicone and latex are used. They are hypoallergenic and have high safety and quality ratings.
On the pharmaceutical market today there are several types of gynecological uterine rings. Each of them has its own characteristics and is used in different clinical situations:
- Urethral rings have a round shape and a thickening on the outside. Such pessaries contribute to the concomitant fixation of the uterus and urethra.
- Mushroom - similar to a ring that has a leg. These types of devices are used only in extreme cases, when other devices do not have the necessary therapeutic effect. Maximum termwearing such a ring is no more than one day.
- Cubic rings resemble a cube, the walls of which are concave inwards. These varieties are equipped with special holes that allow you to remove secretions from the genitals, and are used in the most neglected and severe clinical cases. In addition, cubic uterine rings have a limited duration.
- Cup pessaries are uterine rings that have a characteristic cup-shaped shape with a hole in the center. They are indicated for use in cases of prolapsed uterus in the initial or intermediate stages.
- The Hodge Ring is a device intended for use by patients with some anatomical features, due to which the use of other rings causes severe discomfort. Such a pessary is characterized by an irregular circumference, increased elasticity, flexibility and the ability to accept various configurations.
- Urethral cup - rings that combine the properties of urethral and cup gynecological pessaries. Their wearing is recommended for minor and moderate stages of uterine prolapse with concomitant urinary incontinence.
Besides this, the uterine rings are thick and thin. The most optimal option is selected by the doctor, depending on the characteristics of a particular clinical case.
Uterine ring sizes
The size of the pessary is of fundamental importance. Moreover, it is almost impossible to determine the necessary one on your own. Suitable uterine ring size and shape should revealexclusively by the attending physician after preliminary diagnostic procedures. The size of the ring on the package corresponds to its diameter (from 55 to 95 mm).
When prolapse or slight prolapse of the uterus of the first or second degree, the use of a supporting ring for the uterus is recommended. Pregnant women are prescribed the use of special obstetric rings. In case of problems with urination, uterine rings are recommended, which are equipped with a special levator. If the pathological process reaches the third or fourth stage, the cup-shaped gynecological pessary becomes the best option.
How is the gynecological ring installed?
Consider the user manual. Uterine rings with prolapse of the uterus must be learned to enter independently, since this device is used at home. Initially, this procedure is carried out under the supervision of a medical specialist. Some varieties are placed in the vagina by a gynecologist once and do not require further extraction and re-insertion.
So, how to insert the uterine ring for uterine prolapse?
The procedure is performed in several stages:
- Careful cleaning of the uterine ring with soapy water, washing with water and disinfection.
- Processing the pessary with a special vaginal lubricant or cream for a more comfortable and easy installation, preventing trauma to the mucous membranes and skin.
- Next, the pessary is clamped in the palm of your hand, inserted intovagina, after which the device is straightened so that it is in contact with the cervix and does not exert excessive pressure on it. Installation of the uterine ring is not too difficult.
The duration of the use of a gynecological device depends on its variety, the patient's pathologies and individual characteristics, including anatomical ones. Most gynecological rings (with the exception of cubic and mushroom-shaped) are allowed to be used for a fairly long time period - about 1.5 months. After about 1.5-2 weeks, the patient should come to the doctor for a follow-up examination.
Scheduled visits to the gynecologist should occur one month after using the pessary, after which - after 3 months.
How to insert the uterine ring for uterine prolapse is a common question as different devices are used in different ways. Some types of pessaries are suitable for permanent wear, which requires regular monitoring by a gynecologist. Some models are used exclusively for increased physical exertion, but most of the uterine rings involve daily wear. In this case, the pessary must be pulled out daily, treated with antiseptics and reinserted into the cervical region.
Contraindications for use
The use of the uterine ring for uterine prolapse has some contraindications and limitations. Among them are doctorsgynecologists distinguish the following:
- individual intolerance and high sensitivity to the materials from which the uterine ring is made;
- increased tendency to develop allergic reactions;
- infectious or inflammatory diseases of the genital area, which occur in an acute form;
- colpitis;
- erosion or inflammatory diseases of the cervix;
- violations in the structure and development of female reproductive organs;
- tumor neoplasms (malignant or benign) that are localized in the pelvic area;
- uterine bleeding;
- taking an abortion pill;
- various fetal pathologies during pregnancy requiring abortion;
- during pregnancy - rupture of the amniotic sac.
Gynecological pessaries are also not suitable for women who have a narrow vaginal opening less than 50 mm in diameter.
The above contraindications to the use of the uterine ring are considered relative. In case of inflammatory and infectious pathologies of the gynecological sphere, before installation, the patient is initially prescribed a course of therapy, and only after the acute period of the disease has been stopped, a gynecological pessary is installed.
In addition, permanent pessaries, which are designed to be worn all the time, are not recommended for patients who lead an active, regular sex life or cannot come to a gynecologist's appointment forconstant check-ups. This confirms the instructions for the uterine ring.
Disadvantages and advantages
Gynecological devices in the form of uterine pessaries are characterized by the following advantages:
- Possibility of necessary fixation of the urethra and uterus in cases where surgery is contraindicated.
- Comfortable and easy operation with the right size and shape of the gynecological appliance.
- High efficiency rates at different stages of the pathological process.
- No likelihood of traumatic injury to the genitals.
- Minimum list of contraindications and possible adverse reactions.
This method of therapy for uterine prolapse and other pathologies also has some disadvantages, among which the following are considered the main ones:
- Problems in sex life.
- Possible development of inflammatory processes.
- Does not completely solve the problem, because when the uterine ring is removed, the pelvic organs return to the wrong position.
- Requires regular care and treatment with antiseptics, as well as regular sanitation of the vagina.
- Possible increased vaginal discharge and uterine bleeding.
Some women, according to reviews, from the uterine ring during uterine prolapse experience psychological discomfort due to the presence of a foreign body inside the vagina.
How to extract?
How to pututerine ring, the gynecologist will tell the patient. It will also explain how to remove the system yourself and install it again in the future. The bulk of these devices are easy to install, so there are usually no difficulties during this process.
To remove the gynecological ring, you need to squat down or lift one leg. With the index, thumb and middle fingers, the pessary is captured and gradually removed from the vaginal cavity. This should not give a woman discomfort. After that, the pessary is cleaned, according to the information directly presented in the instructions for use. The introduction of the uterine ring should be carried out in the supine position. To do this, it is necessary to lubricate the gynecological device with a special cream or lubricant to facilitate sliding and prevent injuries to the vaginal mucosa. This confirms the instructions for the uterine ring.
When the uterus prolapses, depending on the degree of pathology, the specialist sets the time period during which the device must be used. It is advisable to do this during the period of physical activity and wakefulness. Usually, patients are assigned to wear a gynecological pessary during the day, and remove it in the evening. The rate of use of such a device is also determined on an individual basis.
A gynecologist may prescribe a uterine ring for 1-5 months or recommend its use for life. It should also be remembered that all varieties of pessaries intended for use in case of prolapseuterus, increase the likelihood of developing inflammatory processes in the vagina. Therefore, all patients are recommended to periodically sanitize the genital tract with the help of special medications. For such purposes, Hexicon candles or Miramistin solution are most often used. In the event of infectious pathologies and changes in the local microflora, other drugs for local treatment may also be prescribed - antiviral, antibacterial, antifungal.
Cost
The price of a gynecological pessary depends mainly on the manufacturer, shape and material of manufacture. The most popular firms today are "Juno" and "Doctor Arabin". The cost of a uterine rubber or silicone ring starts from 300 rubles and reaches several thousand.
If a patient is going to install a pessary in a private clinic, then this will also be a paid procedure - from 500 to 3000 rubles.
It is necessary to select a supporting gynecological system taking into account the stage of uterine prolapse, the age of the patient, the presence of concomitant diseases and the number of births in history. In case of uterine prolapse and prolapse of the bladder with urinary incontinence, mushroom-shaped, cubic and urethral uterine pessaries are preferred. The price category of such systems is usually much higher.
Feedback on fallout uterine rings
Most of the women who used the pessary had a positive opinion about it. Basically, ladies are satisfied with the result of use. After installing the systems, theyelimination of the following unpleasant symptoms was observed:
- pain in the perineum;
- recurrent inflammatory processes affecting the cervix;
- fecal and urinary incontinence;
- bleeding from the genital tract.
You can often hear that the pessary, when falling out or omitted, leads to infection of the vagina, which is accompanied by burning, itching and profuse discharge. This is true, especially with improper use and the absence of regular sanitation of the genital organs. At the same time, such gynecological systems are able to create favorable conditions for the reproduction of pathogenic microorganisms. In this regard, experts strongly recommend that you wear this device for no longer than the specified period of time and handle it carefully.
According to reviews, the uterine ring in case of uterine prolapse makes it possible to postpone surgery for some time. This is especially necessary for patients with the 3rd and 4th stages of the development of such a pathological process. Women also say that they continue to wear uterine rings after surgical treatment. The pessary significantly unloads the muscles of the pelvic region and prevents recurrence of prolapse. However, in this case, it is imperative to choose another device, since for each degree of displacement and prolapse of organs, the size and shape are selected individually. Instructions for use of the uterine ring must be strictly followed.
