Consider the instructions for using the uterine rings for prolapse of the uterus. This pathology in medical science is considered as a hernial protrusion, formed when the pelvic floor is disrupted as a closure 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 determines the displacement of the bladder and rectum.
There is also an incomplete (partial) prolapse of the uterus, which is characterized by a displacement of only the cervix, and complete prolapse, when the uterus is completely beyond the margin of the genital gap. With this pathology, elongation (elongation) of the neck develops. In most cases, the disease is preceded by omissions of the organ - some displacements relative to the normal anatomical level in the pelvic cavity. Reviews of the uterine ring in case of uterine prolapse will be presented at the end of the article.
Causes of Uterine Prolapse
A key role in the development of this pathology belongs to the weakening of the muscles and ligaments of the diaphragm, the anterior abdominal wall, and the pelvic floor, which lose the ability to hold the pelvic organs in a normal anatomical position. In situations of increasing intra-abdominal pressure, the ligaments cannot provide the necessary resistance, which gradually leads to a displacement of the genital organs downward.
Weakening of the muscular and ligamentous apparatus develops as a result of birth injuries, multiple pregnancies, perineal tears, multiple births, radical interventions on the pelvic organs, and 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, pathology occurs in old age, but it can develop even in young nulliparous women.
Description
Silicone uterine ring can be either rubber. It is inserted inside the vagina in order to support the pelvic organs - the uterus, rectum, and bladder. In addition, such devices are used to prevent the progression of the pathological process, normalize the patient’s well-being, and relieve uncomfortable sensations. In modern gynecology, this technique is also used to lower the uterus, its shift towards the vagina, and also during prolapse. The uterine ring with prolapse of the uterus, according to reviews, is an effective way to prevent complications of an inflammatory nature.
Indications for use
Vaginal rings for the uterus are recommended for use in the presence of the following clinical indications and diseases of the female genital area:
- Prolapse of the uterus.
- The movement of the uterus outside the vagina.
- Uterine prolapse, which is characteristic of women aged 45-50 years.
- Female genital therapy before surgery.
- The presence of contraindications for operations on the genitals.
- The need to maintain pregnancy, including multiple pregnancy.
- Diagnosis of urinary incontinence, which occurs in a chronic form.
- Prevention of premature birth.
- Displacement of the urethra, which is accompanied by urinary incontinence.
- Consolidation of the therapeutic result obtained during surgical procedures.
- Uterine prolapse with urinary incontinence.
The uterine ring with prolapse of the uterus helps to cope with the pathology even at the most advanced, severe stage of the disease. Uterine pessaries help patients forget about pain and discomfort, lead a full life.
During 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.
- The presence of a history of spontaneous miscarriages, premature birth, abortion.
As a prophylactic, uterine pessary is recommended to be used after cesarean 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. Materials such as silicone and latex are used to produce rings. They are hypoallergenic and have high safety and quality indicators.
The pharmaceutical market today presents several types of gynecological uterine rings. Each of them has its own characteristics and is used in various clinical situations:
- The urethral rings have a round shape and a thickening on the outside. Such pessaries contribute to 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. The maximum wearing period for such a ring is no more than one day.
- Cubic rings resemble a cube whose walls are concave inward. These varieties are equipped with special holes that allow you to remove secretions from the genitals, and are used in the most advanced and severe clinical cases. In addition, uterine cubic rings have a limited duration of use.
- 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 prolapse of the uterus at the initial or secondary stage.
- The Hodge ring is a device intended for use by patients who have some anatomical features, due to which the use of other rings gives pronounced 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 the urethral and cup gynecological pessaries. Their wearing is recommended for minor and medium stages of prolapse of the uterus with the accompanying violation of urinary incontinence.
In addition, the uterine rings are thick and thin. The most optimal option is chosen by the doctor depending on the characteristics of a particular clinical case.
Sizes of uterine rings
The size of the pessary is fundamental. And to determine the necessary independently is almost impossible. The appropriate size of the uterine ring and shape should be determined exclusively 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).
With the omission or slight loss of the uterus of the first or second degree, the use of a support ring for the uterus is recommended. Pregnant women are prescribed the use of special obstetric rings. In case of problems with urination, uterine rings that are equipped with a special levator are recommended. If the pathological process reaches the third or fourth stage, the most optimal option is a gynecological pessary of a cup-shaped type.
How to establish a gynecological ring?
Consider the instructions for use. In case of uterine prolapse, the uterine rings must be learned to administer on their own, since this device is used at home. Initially, such a procedure is carried out under the supervision of a medical specialist. Some varieties are placed in the vagina by the gynecologist once and subsequently do not require extraction and a new installation.
So, how to enter the uterine ring with prolapse of the uterus?
The procedure is performed in several stages:
- Thorough treatment of the uterine ring with soap and water, rinsing 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 into the vagina, and then the device is straightened so that it contacts the cervix and does not exert excessive pressure on it. Installing the fallopian ring is not too complicated.
The duration of use of the gynecological device depends on its variety, the patient's pathologies and individual characteristics, including anatomical ones. Most gynecological rings (with the exception of the cubic and mushroom) are allowed to be used for a sufficiently long time period - about 1.5 months. After about 1.5-2 weeks, the patient should see a doctor for a follow-up examination.
A scheduled visit to the gynecologist should occur a month after using the pessary, after which - after 3 months.
How to introduce the uterine ring when the uterus prolapses is a common question, since various devices are used in different ways. Some varieties of pessaries are suitable for constant wear, which requires regular monitoring by a gynecologist. Some models are used exclusively for increased physical exertion, but most uterine rings require daily wear. In this case, the pessary must be pulled out daily, treated with antiseptics and injected back into the cervical region.
Contraindications for use
The use of the uterine ring for prolapse of the uterus has some contraindications and limitations. Among them, gynecologists distinguish the following:
- individual intolerance and high sensitivity to the materials of which the uterine ring is made;
- increased tendency to develop allergic reactions;
- infectious or inflammatory diseases of the genital area, which occur in 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), which are localized in the pelvic area;
- uterine bleeding;
- taking a pill intended for abortion;
- a variety of fetal pathologies during pregnancy, which require an abortion;
- during pregnancy - rupture of the amniotic bladder.
Gynecological pessaries are also not suitable for women who have a narrow vaginal opening with a diameter of less than 50 mm.
The above contraindications to the use of the uterine ring are considered relative. In inflammatory and infectious pathologies of the gynecological sphere, before the installation, the patient is initially prescribed a course of therapy and only after stopping the acute period of the disease, a gynecological pessary is established.
In addition, permanent pessaries, which are designed to be worn continuously, are not recommended for patients who have an active, regular sex life or who cannot go to the gynecologist's office for regular check-ups. This is confirmed by the instruction for the uterine ring.
Disadvantages and advantages
Gynecological devices in the form of uterine pessaries are characterized by the following advantages:
- The possibility of the necessary fixation of the urethra and uterus in cases where surgical intervention is contraindicated.
- Convenient and simple operation with the right size and shape of the gynecological device.
- High performance indicators at different stages of the pathological process.
- Lack of likelihood of traumatic damage to the genitals.
- The minimum list of contraindications and possible adverse reactions.
This method of therapy for uterine prolapse and other pathologies has some disadvantages, among which the following are considered the main ones:
- Sexual problems.
- Possible development of inflammatory processes.
- It does not completely solve the problem, since when the uterine ring is removed, the pelvic organs return to the wrong position.
- It requires regular care and treatment with antiseptic agents, 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 prolapse of the uterus experience psychological discomfort due to the presence of a foreign body inside the vagina.
How to extract?
How to put a uterine ring, the gynecologist will tell the patient. He will also explain how to further independently remove the system and install it again. The bulk of these devices are easy to install, so difficulties during this process, as a rule, do not arise.
To remove the gynecological ring, you must squat or raise one leg. With the index, thumb and middle finger, the pessary is captured and gradually removed from the vaginal cavity. This should not cause a woman unpleasant sensations. After that, the pessary is cleaned, according to the information directly provided in the instructions for use. The introduction of the uterine ring should be carried out in a prone position. For this, it is necessary to lubricate the gynecological device with a special cream or lubricant to facilitate sliding and prevent injuries of the vaginal mucosa. This is confirmed by the instruction 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. Typically, patients are prescribed to wear a gynecological pessary during the day, and in the evening to remove it. The course of use of such a device is also determined individually.
The gynecologist can prescribe the wearing of the 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 with prolapse of the uterus increase the likelihood of developing inflammatory processes in the vagina. Therefore, it is recommended that all patients periodically carry out sanitation of the genital tract with the help of special medications. For these purposes, most often used candles "Hexicon" or a solution of "Miramistin." If infectious pathologies occur and local microflora change, other drugs for local treatment can also be prescribed - antiviral, antibacterial, antifungal.
Cost
The price of the gynecological pessary depends mainly on the manufacturer, the shape and material of manufacture. Today, the most popular companies are Juno and Dr. Arabin. The cost of a uterine rubber or silicone ring starts from 300 rubles and reaches several thousand.
If the 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 prolapse of the uterus, the age of the patient, the presence of concomitant diseases and the number of births in history. With 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.
Reviews of uterine rings in case of prolapse
Most women who used the pessary had a positive opinion about it. Mostly ladies are satisfied with the result of use. After installing the systems, they observed the elimination of the following unpleasant symptoms:
- pain in the perineum;
- recurrent inflammatory processes affecting the cervix;
- fecal and urinary incontinence;
- .
, , , . , . . .
According to reviews, the uterine ring with prolapse of the uterus makes it possible to postpone surgery for some time. This is especially necessary for patients with the 3rd and 4th stage of development of such a pathological process. Women also say that they continue to wear uterine rings even after surgical treatment. The pessary significantly relieves the muscles of the pelvic region and prevents relapse of prolapse. However, in this case, it is absolutely necessary 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 observed.