Empowering YOU to be in control

Getting the correct fitting and correct pessary can improve your quality of life drastically

Source: Gehrung pessary suitable for cystocele, rectocele and procidentia

Gehrung Pessary:
The Gehrung pessaries are available with or without support knob in Milex, please note that Bioteque no longer supply the gehrun with knob into the UK.

The Gehrung is suitable for women presenting a cystocele and/or rectocele. They are also very effective treating procidentia where the uterus tends to herniate when other pessaries are used.

Fitting the Gehrung: If being fitted using the one with knob support, this gehrung should be fitted with a full bladder then you will be asked to empty the bladder post fitting. This ensures the knob is positioned properly and you can empty your bladder properly. The one without the knob, it isn’t necessary to fit with a full bladder, however the patient must be able to empty the bladder fully when the gehrung is inserted.
I would suggest you irriagate the vagine prior to fitting, this removes any loose membrane and excess secretions, which could potentially get trapped between the vagina and pessary and cause an unpleasant smell later on.

Please be aware that the gehrung is one of the most difficult pessaries to fit and should only be fitted and removed by your medical professional trained in pessary fitting.

Those with endometriosis, this may not be suitable for you and should be discussed with your doctor.

The gehrung is made from medical grade silicone and the arch can be manipulated to support the rectocele.

Gehrung fitting pessary

Are you a medical professional and would like to know more about our educational program on pessaries. Please get in touch via www.candgmedicare.com

Order gehrung pessaries

The Bladder and Caesars

sue croft physiotherapist blog

I recently read some research (BMJ Open 2013:3:e002789)  looking at the Caesarean rate in public and private hospitals in Western Australia. It looked at births to nulliparous women during 1996-2008 (155646). The study looked at the Caesar rate depending on the source of funding (private versus public hospital) and found 29% ( 45903) in total were performed. 24803 were performed in-labour meaning that because of foetal or maternal distress, and 21100 were performed pre-labour, meaning they were  planned C section. The study concluded that an increase in the pre-labour caesarean delivery rate for private patients has been driving the increase in C section rate for nulliparous women since 1996.

Now the point of this blog is not to draw attention to the many pelvic floors that are not undergoing the potential damage that pushing a baby out may cause ie the Caesar rate, but rather to reiterate the importance of all women undergoing any gynaecological surgeryincluding Caesareans, to…

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Dr Arabin Cerclage Pessary

Dr Arabin Cerclage Pessary

Vaginal progesterone, cerclage or cervical pessary for preventing preterm birth in asymptomatic singleton pregnant

women with a history of preterm birth and a sonographic short cervix.
Reference: Ultrasound Obstet Gynecol 2013; 41: 146–151 Published online 17 January 2013 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.12300
and M. GOYA‡
*Department of Women’s and Children’s Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK; †Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Division, University of Alabama, Birmingham, AL, USA; ‡Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain; §Department of Biostatistics, University of Alabama, Birmingham, AL, USA
Objective To compare the outcome of pregnancy in cohorts of women with singleton pregnancy and history of preterm birth and sonographic short cervix managed with different treatment protocols, namely cerclage, vaginal progesterone or cervical pessary.
This was a comparison of three management protocols for women with singleton pregnancy and a high risk of preterm birth because of a prior spontaneous preterm birth before 34 weeks and a shortened cervical length detected by transvaginal ultrasound. The study included 142 women who were initially treated with cerclage (USA), 59 with vaginal progesterone (UK) and 42 with cervical pessary (Spain). Perinatal outcomes were compared between the three cohorts.
There were no statistically significant differences in perinatal losses, neonatal morbidity and preterm births among the three groups, apart from a higher rate of preterm birth before 34 weeks’ gestation after treatment with vaginal progesterone in comparison with treatment with cervical pessary (32% vs 12%; relative risk (RR)=2.70; 95% CI, 1.10–6.67). When only the
subgroups of women with cervical length <25 mm, irrespective of gestational age, were compared, the difference between these two cohorts was not statistically significant (RR=2.21; 95% CI, 0.83–5.89).
Cerclage, vaginal progesterone and pessary appear to have similar effectiveness asmanagement strategies
in women with singleton pregnancy, previous spontaneous preterm birth and short cervix. Direct randomized comparisons of these strategies, or combinations thereof, are needed to determine optimal management.
Cerlage Dr Arabin in position

Excellent article. I love their blog

Vitamin A

Vitamin A.

APOPS new logo jpgCredit to Sherrie Palm founder Associateion for Pelvic Organ Prolapse Support

It’s flu season; you’re hacking and hacking until you feel like your bottom end is going to blow out. And it just might be. if you’re like me you start to ramp up the germ-phoebe aspect of your personality around this time of year. We all start paying more attention to washing our hands, get nervous about grabbing the door at stores we shop at, walk the other way when we hear someone  coughing. No one wants to get the flu. Yet despite the extra protective measures we take, we somehow manage to contract it. The majority of us are exposed to hundreds of germ infested surfaces every day; there’s just no way to get around it beyond wrapping ourselves in one of those protective bubbles. Not a very user friendly way to avoid getting sick.

I recently returned from a trip overseas and had concerns about being in airplanes and airports, knowing that the odds of my catching a bug were increased by being exposed to so many people in an enclosed environment. Every time someone coughed on the plane I thought to myself “keep your hands off your face, keep your hands off your face,” reciting it to myself like some kind of magical mantra that would protect me. Although I felt badly for the young child coughing non-stop a few rows up from me on the airbus, I equally worried that somehow the germs would float back to me in the recycled air of the plane.

Somehow I managed to make the long journey in both directions and come home with my body flu-free. Lucky me, I figured now I could relax. Then the inevitable happened-……read more Read the rest of this entry »

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