Perforated Cerclage Pessaries Dr ARABIN. To support the cervix in pregnant patients with threatening preterm labor (funneling / short cervical length).

The perforation allows drainage of discharge.

This Cerclage pessary is used to treat pregnant women with cervical incompetence in order to support the cervix and turn it towards the sacrum.

It may be indicated in pregnancies with a history of premature labour, multiple pregnancies or mothers who are exposed to physical strain (e.g. standing for a long time). It may also be indicated in pregnant women suffering from prolapse of the genital organs.

Using transvaginal sonography in recumbent or upright position we have established normal values for the cervical length and an opening of the cervical os (funnelling) for singleton and twin pregnancies.

Low values of the cervical length and high values of the opening of the cervical (Funneling) help identify patients who might benefit from cerclage pessary placement.

Inserting a Cerclage Pessary:

This cervix 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.

Sizes and Models – Cerclage Pessary

Perforated 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

Additional Information

Application: The cerclage pessary is made of flexible comfortable, tissue tolerant silicone. Like all silicone cervix pessaries it is elastic, and can thus be folded and inserted without pain.

The cerclage pessary is designed for the treatment of pregnant women.

It is to support the cervix especially by patients with additional complaints of prolapse (,,painful pressure downwards, mostly during standing and walking”), pregnant women who are exposed to physical strain (e.g. standing for a long time) or increased intrauterine pressure, or when an ultrasound shows signs of an incompetent cervix.

Before insertion bacterial swabs should be performed to exclude bacterial colonization.

The treatment should start early in pregnancy before the cervix might be effaced (at about 15-20 weeks)

.Transvaginal ultrasound at regular intervals can help to determine funneling of the internal os and detect the cervical length.

This cervix pessary is not meant to close the cervix but rather to support it and to shift the cervix towards the sacrum.

Sizes Perforated Cerclage Pessaries:

Cerclage pessaries differ in their outer diameter (65mm to 70mm) as well as in the height of the curvature (each 17mm, 21mm, 25mm, 30mm).

The inner diameter is either 32mm or 35mm. The higher cervix pessary models are preferred under more severe conditions.

Use Perforated Cerclage Pessaries:

The cerclage pessary is inserted in the recumbent position by the obstetrician.

It is vital that the curvature of the pessary faces upwards so that the larger diameter is supported by the pelvic floor.

The pessary is folded and pushed into the vaginal fornix.

While doing this, the cervix should be placed within the upper ring diameter.

The obstetrician should control that the cervix is not surrounded too firmly by the upper ring of the pessary.

After the insertion, the patient is asked to stand up and should hereby not feel the cervix pessary when it is correctly placed.

Possible prolapse complaints are directly redressed, which can motivate patient and team physician to continue with the treatment.

The insertion of the cervix pessary can be facilitated by applying a gliding compound, preferably an antibiotic cream preserving the natural flora.

The pessary may stay until delivery, or at least until 37 weeks respectively. In cases of increased discharge it may be changed and cleaned in between, but this is not mandatory if manipulations are to be better avoided.

Vaginal sonographic examinations can help identifying the cervical shape and length, the position of the pessary can easily be controlled manually during routine controls.

Side Effects/Complications:

The right positioning of the cervix pessary (with the curvature and the smaller diameter upwards) is the key to success of the treatment, otherwise the supporting effect is insufficient.

There might be some increase of abacterial discharge, however, the spectrum of the vaginal flora will not be substantially altered.

Advice:

The product should be used by one patient only. It can be stored by room temperature. The pessary can be cleaned under warm running water without using disinfectants.

Product Registration Perforated Cerclage Pessaries:

This product is currently registered in Europe, Malaysia, Japan, Thailand, Vietnam, Korea, Brazil, Chile, Columbia, Cuba, Russia and all the former countries of the Russian Empire.

In Canada and the US, the pessaries are only allowed to be used within research studies or when a physician has informed the patient that he is using a product off-label.

IMPORTANT – MUST READ

The Cerlclage pessary is NOT FDA listed in the United States of America, this product can only be used for research purposes and clinical trials and must be purchased directly from Dr Arabin.

The post Perforated Cerclage Pessaries Dr Arabin – To support the cervix in pregnant patients | DPM49ASQ/65/25/32 appeared first on Ortohispania.

Pelvix Concept Pelvic Floor Rehabilitation Exerciser, Prevention – Post Preganancy – Incontinence – Sexualidad.

• Mothers: preparing for pregnancy and postpartum.
• Menopause: strengthen the muscles and prevent incontinence and loss of sexual sensitivity.
• Athletes: Sport damages this musculature, so it is necessary to strengthen it.
• To improve sexual satisfaction.

Pelvix Concept Pelvic Floor Rehabilitation Exerciser

A revolutionary progressive pelvic floor exerciser designed for pelvic floor rehabilitation.

What’s Unique About Pelvix?

This system of progressive weights provides a complete strengthening solution in one single device.

The unique Pelvix ergonomic design and ribbed surface provides for excellent fit that is well retained within the vagina.

This sets this exerciser apart from some of the other pelvic exerciser designs.

Pelvix Concept Rehabilitation:

• Pelvic floor strengthening
• Post natal pelvic floor recovery
• Bladder control
• Improved sexual sensation and grip strength

Pelvix Concept Features:

• Unique ergonomically shaped exerciser
• Angle design for pelvic floor muscles
• Ribbed medical silicone exterior allows for comfort fit
• Readily retained within the vagina
• Well suited to women of all ages
• Easy insert and removal with retraction leash
• 5 progressive weight combinations in one exerciser

Pelvix Concept Contents:

• Pelvix Concept device
• 3 weighted balls
• Compact storage box
• Satin pouch
• Instruction guide

How to Use Pelvix for Rehabilitation:

• Rinse and dry Pelvix before first use
• Apply a small amount of water-based lubricant* to the top of the unweighted device (opposite end to the retraction leash)
• Insert Pelvix so that the base can be felt approximately 2cm within the vagina (not as high as a tampon)
• Exercise lying down or standing upright by lifting and squeezing your pelvic floor muscles around the device
• Relax your pelvic floor back to resting level
• Rest briefly before your next attempt
• Repeat this action for up to 8-12 repetitions holding each exercise for up to 10 seconds at a time
• Repeat this routine up to 3 times in a day
• *Water-based lubricants are safe to use and will not erode the medical grade silicone coating unlike non water-based lubricants

How to Progress Pelvic Floor Strengthening:

When you can comfortably complete your exercises with the unweighted Pelvix, simply unscrew the body of the exerciser and start to add weight incrementally as follows:

STEPS

1: Without weighted ball – 17g
2: Small 15mm ball – 26.2g
3: Medium 18mm ball – 34.4g
4: Large 22mm ball – 51.5g
5: Pelvix + 15mm small + 22mm large balls – 60.7g

When you can perform the recommended number of exercises with ease using a particular weight you are ready to progress to the next weight.

Progress within your range of personal comfort to provide additional challenge with added resistance to promote pelvic floor strengthening.

Cleaning Pelvix Concept

Wash with warm soapy water, rinse and dry thoroughly after use
Wash your Pelvic Floor Exercisers with water, neither hot nor cold .

To clean Pelvic Floor Exercisers, use a mild soap, natural antibacterial solution or specific tissues.

Conservation 

Keep your Pelvic Floor Exerciser in a cool, dry place isolated from direct sunlight and extreme temperature changes .

Find contact material that is made to avoid possible allergic reactions to components or deterioration by incorrect use of lubricants creams, fluids or soaps unsuitable or incompatible with his composition.

Remember that the lubricants with bases called ” water ” are compatible with all materials.

If you will not use your Pelvic Floor Exerciser ( contact materials not rigid) for a long period of time, should save it under a thin layer of natural talc without flavorings or additives to better preserve its qualities.

Warnings: Pelvix Concept should not be used during pregnancy or menstruation. Nor if you have been diagnosed with a prolapse, or have a vaginal infection.

10 step guide to pelvic floor safe exercise

This guide has been reproduced with kind permission from Michelle Kenway, physiotherapist and author of Inside Out.

It provides 10 simple and practical tips to modify an exercise program to be pelvic floor safe.

The post Pelvix Concept Pelvic Floor Rehabilitation Exerciser, Prevention – Post Preganancy – Incontinence – Sexualidad, Ref. DPM4540461 appeared first on Ortohispania.