Patient's question:
Detailed medical condition and consultation purpose: Childless, mild uterine prolapse, how to treatDuration and course of the current illness: One week
Current general condition: 4 cm from cervix to vulva
Medical history: About one year. Recently worsened
Previous diagnoses and treatment history and effectiveness: No treatment
Auxiliary tests:
Others:
Doctor's answer:
Hello, patients with uterine prolapse are recommended to adopt a comprehensive approach that combines traditional Chinese and Western medicine, as well as treatment, nutrition, and rest. In terms of treatment methods, they can be categorized into non-surgical therapies such as the use of pessary, oral Chinese herbal medicine, acupuncture, and sitz baths, as well as surgical repair. Due to the potential impact on future vaginal childbirth after surgery, the procedure is only suitable for severe cases and women who no longer plan to have children.### I. Pessary Therapy
#### (1) Pessary and Its Function:
Pessaries have long been used to treat uterine prolapse. Through continuous improvements by various provinces and cities in their prevention and treatment efforts, this method has achieved good results. It is simple, easy to implement, and allows patients to manage it themselves, making it very popular among rural patients and suitable for all degrees of uterine prolapse. There are many types of pessaries, and the most commonly used ones are plastic mushroom-shaped pessaries. They are categorized into three sizes (small, medium, and large) based on the diameter or transverse diameter of the base (6 cm, 5 cm, and 4 cm, respectively). The base comes in two shapes: circular and elliptical. The medium-sized pessary is the most frequently used. The handle is about 5 cm long and curves forward to fit the vaginal curvature.
The principle of pessary treatment lies in using the pubococcygeus muscle to support the pessary base in the vaginal fornix, preventing the cervix from descending and maintaining it at the level of the ischial tuberosity, with the handle resting against the vaginal opening. For mild cases, no additional support is needed. If the vagina is excessively (loose), a menstrual pad may be used to support the handle, or a strap or plastic cord can be tied to the top of the handle and secured on the waistband to prevent it from falling out.
#### (2) Pessary Size Selection:
It is advisable to choose a size slightly larger than the genital (pubococcygeus) fissure. Generally, the transverse diameter of the fissure is most commonly 4 cm, so the medium-sized pessary is most frequently used.