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PESSARY INSERTION

REASON FOR VISIT:

•Cystocele
•Rectocele
•Enterocele
•Uterine prolapse
•Stress incontinence

RISK ASSESSMENT

•PID
•Active pelvic infection
•Diabetes

PREPARATION OF THE PATIENT:

Before procedure estrogen therapy was given to the patient

ANESTHESIA:

None

POSITION OF THE PATIENT:

Lithotomy Position

THE PROCEDURE

•Patient was in lithotomy position


•Middle finger was inserted behind the cervix in the posterior fornix
•Index finger was inserted against the pubic notch
•The distance between 2 fingers was used as a starting point in
pessary sizing.
•Fingers were withdrawn
•Proper pessary ring was selected
•The fitting ring was folded in half
•Entering end was lightly lubricated
•Pessary was inserted into the vagina so that part of the ring is
behind the cervix and the opposite side is behind the pubic notch
•Sweep finger around the perimeter of the ring to check for pressure
points.

DURATION

___________min

AFTER CARE

•To prevent infections and odours, an acidifier/ estrogen must be


applied vaginally 2 or 3 times weekly.
•Use oral/ transdermal estrogen/ an estradiol-17 ring
•Remove and wash the pessary once in______ wks/months

COMPLICATIONS

•Vaginal infection
•Erosions
•Vaginal ulcer
•Discharge
•Odour
•Pain
•Bleeding
•Failure to reduce the prolapse
•Expulsion