UTERINE RINGS (synonym vulval pessaries) — the mechanical devices used at loss and a falling of the womb and vaginas to their deduction in the correct situation. M to. make preferential of plastic materials, is more rare — from the vulcanized rubber. Many models M. were offered to.; in a wedge, practice the simplest of them are accepted (fig., 1 and 2). Apply M. to. To Shulttsa, Meyer, Schatz, however the greatest distribution was gained by pessaries of Godzha.
Indications: prolapse of the uterus, vaginas (see) at elderly or seriously ill patients of women, the Crimea operational treatment is contraindicated; failure of the patient from operation. Contraindications: acute or subacute inflammatory diseases of bodies of a small pelvis; impossibility by means of M. to. to redeem normal situation of a uterus; the constant sensation of discomfort connected using M. to.
The size M. to. select individually; M to. shall be sufficient by the size, but not too small or big that it was not expelled from a vagina at a natuzhivaniye or cough and at the same time did not put excessively strong pressure upon walls of a vagina.
Before introduction to M.'s vagina to. subject to disinfecting: plastic place in disinfecting solutions, rubber boil. M to. from plastic previously immerse in warm sterile water then it contracts easier. Site M. to., the Crimea enter a ring into a vagina, it is necessary to oil sterile vaseline or vegetable. Finishing in a vagina, M. to. shall reach the correct position: the upper site — above and behind a neck of uterus, lower — below and ahead of a neck of uterus. Stretching an upper part of a vagina between the back arch and a symphysis, M. to. prevents a prolapse of the uterus through narrower lower part of a vagina. At the correct selection of M. to. and the correct arrangement it in a vagina the patient shall not feel M. to. as foreign body.
Introduction and M.'s removal to. the doctor makes a hand; use for this purpose of tools is inexpedient. M to. from plastic no more than 6 months, from rubber — no more — 8 weeks can serve. Because M. to. (rubber it is considerable more often than plastic) cause development of local inflammatory reaction of a wall of a vagina, the patients applying M. to., shall be exposed ginekol, to inspection, including tsitol, a research of contents of a vagina (at least 1 time in 3 months).
The following complications at long carrying M. are described to.: locks (see), incontience of urine (see), colpitis (see), cervicitis (see), an ulceration of a wall of a vagina, development of hems and thereof as if M.'s growing to. into a wall of a vagina, formation of vaginovesical or rectovaginal fistulas (see. Urinogenital fistulas ), cancer of a vagina (seldom). In this regard, and also improvement of a technique and technology of operations M.'s use to. becomes more and more limited.
Bibliography: The multivolume guide to obstetrics and gynecology, under the editorship of L. S. Persianinov, t. 4, book 2, page 365, M., 1963; Benson R. Page of Current obstetric and gynecologic diagnosis and treatment, Los Altos, 1976: Kepp R. u. Staemm-ler H. J. Lehrbuch der Gynakologie, Stuttgart, 1977.
B. L. Gurtova.