Pelvic Organ Prolapse Education

Transcription

1 Pelvic Organ Prolapse Education Product range to offer patients a better quality of life Pessaries in this catalogue are from various manufacturers. All are made from medical grade silicone

2 Pessaries come in all shapes and sizes. It is crucial you find the right one to enable the prolapse to be properly supported

3 IncoStress Designed by women for women International award winning Incostress. This pessary may be used to treat stress incontinence, OAB, nocturia, mild cystocele, mild rectocele It supports the urethra and bladder neck. Allows light support to the pelvic floor and allows the user to identify the pelvic floor muscles to carry out pelvic floor exercising. Maybe worn nigh and /or day or as preferred. one size medical grade silicone. 28g 55mm length 25mm width

4 T Pessary type B or type R Designed by women for women The T-Pessary is specifically designed for the treatment of cystocele and rectocele. The cylindrical shape repositions the bladder in the anatomically correct position. The size relates to the diameter and length of the device in mm. Medical staff ask about the size fitting set Supplied with Ladysoft lubricant Sizes 20/50mm 25/55mm 32/79mm 36/80mm 42/70mm 46/84mm

5 Ring Pessary Please specify with or without membrane with your order. The ring pessary, available with or without a supporting membrane, is primarily used for a mild first degree uterine prolapse or a cystocele. An in tact pelvic floor is required for an effective therapy of this pessary. White 0 (44mm) 1 (51mm) 2 (57mm) 3 (64mm) 4 (70mm) 5 (76mm) 6 (83mm) 7 (89mm) 8 (95mm) 9 (102mm) Blue 50mm 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm 95mm 100mm

6 Urethra Pessary This pessary may be used to treat stress incontinence or a mixed form of urge and stress incontinence with or without previous surgery. The pelvic floor support s the pessary. The pessary consists of an aluminium ring inside the medical grade silicone pessary to keep its shape. The thicker part of the pessary is for support to the urethra. This pessary can be administered and removed by the patient herself. 45mm 50mm 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm 95mm 100mm Sizes range from 45 to 100 mm in 5 mm increments. The urethra pessary with the smallest diameter that supports the pelvis should be prescribed

7 Donut and Thick Pessary The Donut and Thick pessary may be used to manage a (mild) second or third degree uterine prolapse, a cystocele or/and rectocele. This pessary is often used by postmenopausal women, is easily compressed for insertion and removal Donut 0 (51mm) 1 (57mm) 2 (64)mm) 3 (70)mm) 4 (76)mm) 5 (83)mm) 6 (89mm) 7 (95)mm) Thick 50mm 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm 95mm 100mm

8 Short or Long Stem Gelhorn Pessary The Gelhorn pessary is measured by the circumference of the bowl s diameter. The height of the stem is 38mm tall and can be easily folded for easy insertion and comfort. The stem is 3.2cm long Patients with grade 2 or 3 uterine prolapse are treated with the Gelhorn pessary, in cases where urethra, ring or bowl pessaries do not help. Gelhorn Pessary is also used to relieve the symptoms of a cystocele or rectocele The stem knob is for easy removal. 38mm 44mm 51mm 57mm 64mm 70mm 76mm 83mm 89mm

9 Club Pessary with/without drainage holes For treating severe prolapse. Equipped with a shaft which prevents tilting and slipping. A descent of the pelvic floor or prolapse occurs when organs leave their accustomed place. Normally, the uterus and vagina are attached by connective tissue tape-style and by a strong shell around the vaginal wall at the bony pelvis. With a weakening of the pelvic floor muscles, connective tissue structures give way, so the vagina falls down. The position of bladder and rectum can be affected. About one in three women over 45 years suffer from a more or less severe form of such a genital prolapse. A conventional method of treatment with pessaries (selected by the physician) can resolve many of the symptoms. 50mm 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm The Club Pessary is made from special medical silicone and was developed for treating severe prolapse. It has proved very successful in past years. It is equipped with a shaft which prevents the ring from tilting and slipping. After about three weeks, a smaller Pessary should be inserted as the lower vaginal tissue shrinks relatively fast. Often the pessary can be replaced by a cube after a couple of weeks. Insertion and removal of the Club Pessary is more difficult than with any other pessary.

10 Cube Pessary Please indicate with or without perforations when ordering The Cube pessary, available with or without perforations, may be used to relieve the symptoms of a cystocele or rectocele as well as a second or third degree uterine prolapse where the pelvic floor is too weak too weak to support ring pessaries. Remove daily Size chart white cube Size chart blue cube 25mm 29mm 32mm 37mm 41mm 45mm 0 (25mm) 1 (29mm) 2 (33mm) 3 (37mm) 4 (41mm) 5 (45mm) 6 (50mm) 7 (56mm) 8 (63mm) 9 (70mm) 10 (75mm)

11 Without perforations Tandem Cube Pessary with/out drainage holes The tandem pessary comprises of two cubes one slightly smaller than the other. Used to treat patients with severe uterine or vaginal vault prolapse. The tandem pessary may be considered when the vagina cannot retain a single cube pessary. In cases where the pelvic floor is too weak to retain Incostress the tandem may be useful to treat stress incontinence. 25mm 29mm 32mm 37mm 41mm 45mm Sizes are measured according to the length of edges: -. Also available with perforations for drainage of discharge

12 Marland Pessary The Marland pessary, available with or without a supporting membrane, is used to relieve the symptoms of a second or third-degree uterine prolapse, a cystocele, or a rectocele. This pessary 's elevated platform may also relieve stress urinary incontinence. 57mm 64mm 70mm 76mm 83mm 89mm 95mm

13 Shaatz Pessary The Shaatz pessary may relieve the symptoms of a cystocele as well as a second or third-degree uterine prolapse. Its convex shape insures a snug fit while the drainage holes permit easy removal. Measured in millimetres 38mm 44mm 51mm 57mm 64mm 70mm 76mm 83mm 89mm

14 Folding dish with knob/support and Sieve cup pessary For stress urinary incontinence with (grade 1-2) slight to mild uterine prolapse & mild cystocele, these pessaries can be autoclaved and are made of medical-grade silicone. A viable pelvic floor is needed to retain this. 55mm 60mm 65mm 70mm 75mm 80mm 85mm 50mm 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm 95mm 100mm Sieve cup may also be used upside down

15 Bowl Sieve bowl pessary This Bowl pessary may be used in patients with complaints of less severe prolapse. Ideal for grade 1 prolapse where the pelvic floor can act as support for the pessary. Mild forms of pelvic relaxation and prolapse. In patients with a cystocele the pessary supports both the medial and the lateral defect. An intact pelvic floor is required for an effective therapeutic success of this pessary. Bowl pessaries are also available with perforations for drainage. 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm 95mm

16 Folding urethra bowl and urethra ring pessary For stress urinary incontinence with (grade 1-2) slight to mild uterine prolapse & mild cystocele, these pessaries can be autoclaved and are made of medical-grade silicone. A viable pelvic floor is needed to retain this. 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm 45mm 50mm 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm 100mm bowl may also be used upside down

17 Gehrung/folding pessary Support for cystocele and rectocele. Relief for a second or third-degree uterine prolapse. This pessary can be manually shaped to accommodate individual problems and anatomies. 50mm 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm 95mm

18 Hodge with/without support pessary The Hodge pessary is made from medical grade silicone with an aluminium inner to allow for shaping. Available with or without a supporting membrane, is commonly used for a first or mild second-degree uterine prolapse and may also relieve a cystocele.. The Hodge Pessary can be used to manage stress incontinence, if ring pessaries are not tolerated because of anatomical aberrations, frequently caused by previous surgery. These pessaries, designed to be manually formed for individual fitting. Helpful in cases of repeated miscarriage due to an incompetent cervix by repositioning the weight of the growing foetus. Blue 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm 95mm White 65mm 70mm 75mm 80mm 85mm 90mm 95mm 100mm 105mm 110mm

19 Hodge with knob pessary For stress urinary incontinence in a woman who has a small vaginal introitus, the Hodge with Knob is autoclavable, made of medical-grade silicone, and latex free. Helpful in cases of repeated miscarriage due to an incompetent cervix by repositioning the weight of the growing foetus. sizes #0: 2-3/4" x 1-3/4 #1: 3" x 1-7/8" #2: 3-1/4" x1-15/16" #3: 3-1/2" x 2" #4: 3-5/8" x 2-1/8" #5: 3-3/4" x 2-1/4" #6: 3-7/8" x 2-3/8" #7: 4-1/4" x 2-1/2" #8: 4-5/8" x 2-5/8" #9: 5" x 2-3/4"

20 Hodge Risser and Smith The Smith, Hodge, and Risser pessaries are collectively referred to as lever pessaries. These devices were originally intended to treat uterine retroversion. They may be used for mild or up to a grade 2 uterine prolapse and cystocele. May also be used in pregnancies complicated by cervical insufficiency. Hodge with knob Good for a shallow pubic notch

21 Cerclage Pessary Cerclage Pessaries can prevent cervical incompetence and, thereby, late abortion or premature delivery without surgical intervention. Cerclage Pessaries can prevent cervical incompetence and, thereby, late abortion or premature delivery. Nowadays this riskless therapy is an alternative to surgical intervention. Both methods show a success rate of %. Cerclage Pessaries can be securely placed due to their bowl shape and curvature heights of 17, 21 or 25 mm. Cerclage pessaries are inserted by an obstetrician, depending on the diagnostic findings, after approx. week 16. Cleansing or replacement is required depending on clinical or bacteriological fluoric findings. Inserting the Cerclage Pessary The pessary can easily be folded and inserted without pain. Before the application, it is recommended to exclude and treat if necessary cervical or vaginal infection. In general, Cerclage pessaries should have a height of 17-25mm in singleton and a height of 25-30mm in twin or multiple pregnancies or pregnant patients with complaints of prolapse. The width of the upper and lower diameter should be chosen depending on the individual constitution of the pregnant patient.

22 Cerclage Pessary Type A and ASQ To support the cervix in pregnant patients either with complaints of prolapse(painful "downward pressure" during standing and walking) the pregnant woman exposed to physical strain (eg. Standing for a long time)and/or in patients with threatening preterm labour (funnelling/short cervical length). Cerclage pessaries are classified according to; The lower larger diameter - 65mm or 70mm The height - 17mm, 21mm, 25mm or 30mm The diameter of the upper hole - 32mm or 35mm 65/17/32 65/17/35 65/21/32 65/21/35 65/25/32 65/30/35 65/25/35 70/17/32 70/17/35 70/21/32 70/21/35 70/25/32 70/25/35

23 Cerclage Pessary Hamann & Jorde with lubricant Mechanism of action: The Cerclage & Support Pessary constricts the cervix, the central opening fixes the cervix and pushes it backwards. By supporting the cervix, pressure is taken off it. Intrauterine pressure is shifted to the front wall of the uterus due to the tilted dorsoventral pessary position and sacralization of the cervix uteri. At the same time the Cerclage & Support Pessary ensures a formation or reshaping of the shortened and partly open cervix. Due to the collective impact of all of the previously mentioned, the lower pole is protected. Sz.I - Ø 30mm 59/57/14mm Sz.II - Ø 35mm 76/70/14mm Sz.III - Ø 35mm 83/80/14mm The size refers to diameter, length, width and height of the pessary.

24 Inflatable Pessary white mm mm mm mm Remove nightly Dimensions measured from outside of diameter: Medical grade silicone. Vaginal or uterus prolapse and / or incontinence, when regular pessaries don't achieve satisfactory results. Available in latex or silicone. (picture denotes silicone type)

25 Bioteque Pessary Fitting Sets Pessary Fitting sets come in display boxes and are ideal to measure your patient for the correct size pessary Available pessary fitting kits include sizes #2 57mm, #3 64mm,#4 70mm,#5 76mm,#6 83mm, #7 89mm Ring w Support Pessary Fitting Set (sizes #2-7) Oval Pessary Fitting Set ( sizes #2-7) Gellhorn Pessary Fitting Set (sizes #2-7) Ring pessary Fitting Set (sizes #2-7) Cube Pessary Fitting Set (sizes #2-7) Dish Pessary Fitting Set (sizes #2-7)

26 Pessary Fitting Sets Dr Arabin Pessary Fitting sets come in display boxes and are ideal to measure your patient for the correct size pessary

27 Pessary Fitting Sets Milex Pessary Fitting sets come in display boxes and are ideal to measure your patient for the correct size pessary

28 Chart of pessaries

29 Vaginal Dilators Vaginal dilators play an important role in preventing adhesion and scarring of the vaginal area and have a positive affect the healing process and rehabilitation after episiotomies or vaginal operations. Training can prevent or minimise pain.

30 V Brace Fembrace support The V-Brace by Fembrace is a revolutionary support garment especially designed for the relief of painful and embarrassing symptoms associated with Genital Prolapse and pregnancy related Varicose Veins of the Vulva (Vulvar Varicosities). The V-Brace is a garment-like cross-elastic support truss with straps threaded through a sleeve in the crotch of the panty. The V-Brace cross elastic truss supports and lifts the vaginal area, helping to relieve pain, discomfort, pelvic fullness and abdominal strain. The V-Brace also reduces the problems of incontinence and urinary frequency and can even effectively help to minimise perineal oedema following surgery.the V- Brace is discreet and so comfortable its like wearing normal underwear. Eliminates discomfort of: Vulvar Varicose veins Hip, leg and pelvic pain Urinary frequency Prolapsed bladder or/and uterus Painful symptoms of vaginal prolapse Perineal oedema Incontinence Cystocele Rectocele Sizing The sizing is based on the upper hip measurement taken at the level of the pelvic iliac crest just below the belly button. You measure yourself in the same way as you measure for normal underwear and clothing. Simply measure the circumference around your belly at its widest slightly protruding part. You can feel your iliac crests on the sides of your body just below your waist.

31 Bellecup menstrual cup Designed for women with pelvic organ prolapse and/or women who suffer with endometriosis. The Bellecup is made from medical grade silicone. It s unique shape allows support of the organs during menstruation. It hold more fluid than other cups making it ideal for those with extreme heavy blood flow. Very comfortable to wear.

32 Pessary & Probe disinfectant 250ml A non hazardous, broad spectrum medical device disinfectant. PH balanced, so it is safe on sensitive skin. It disinfects and protects your products, providing an antibacterial shield effective against % of all known germs. (including MRSA, C,diff, Ecoli, Salmonella) Due to its hydrophobic properties, Pessary & probes forces itself into hard to reach bacteria breeding and then breaks down the developing bacteria. The product then forms a protective film excluding further bacteria from settling. Ideal for pessary fitting sets Traditional disinfectants stop working when they dry, Pessary & Probe continues to work. Simply soak the pessary or medical device instrument in the solution for 30 seconds, remove and allow to dry.

33 Recommended books 164 pages self help book about total pelvic floor control. Written in a way you won t forget Proven to help with: Incontinence control Easier childbirth Improve intimate relations Tighter pelvic floor muscles Hardback cover 130 pages self help no nonsense, easy to understand about living with pelvic organ prolapse and how to deal with it.

34 Contact us Pelvic Organ Prolapse Education E: T: T:+44 (0)