Prolapse Pessaries 1st and 2nd degree 3rd degree

Stress Urinary Incontinence /Incompetent Cervix Cystocele and Retrocele Incompetent Cervix

Incontinence Incontinence Pessaries and Devices

Hodge Silicone Folding Pessary Manually Shapeable Milex Code: KPEH + Size HODGE designed for patient with limited pubic notch. Directing Pessary behind cervix Pessary in position

Hodge With Support Silicone Folding Pessary Manually Shapeable Milex Code: KPHS + Size HODGE with support designed for patient with limited pubic notch and mild cystocele. Size A B   Inches mm Inches mm 0 2 3/4" 70 1 3/4" 44 1 3" 76 1 7/8" 48 2 3 1/4" 83 1 15/16" 49 3 3 1/2" 89 2" 51 4 3 5/8" 92 2 1/8" 54 5 3 3/4" 95 2 1/4" 57 6 3 7/8" 98 2 3/8" 60 7 4 1/4" 108 2 1/2" 64 8 4 5/8" 117 2 5/8" 67 9 5" 127 2 3/4" 70

Smith Without Support Milex Code: KPES = Size SMITH designed for patient with well-defined pubic notch. Pessary in position

Size A B   Inches mm Inches mm 0 3 1/8" 80 2" 51 1 3 1/4" 83 2 1/8" 54 2 3 1/2" 89 2 1/4" 57 3 3 3/4" 95 2 3/8" 60 4 4 1/4" 108 2 1/2" 64 5 4 1/2" 114 2 5/8" 67 6 4 3/4" 121 2 3/4" 70 7 5" 127 2 7/8" 73 8 5 1/2" 140 3" 76 SCREENED AREA indicates sizes recommended for office fitting. With these sizes, you will be able to fit 85.2% of patients.

Risser Silicone Folding Pessary Manually Shapeable Milex Code: KPRI = Size RISSER (A modification of the HODGE pessary). Designed for patient with very shallow pubic notch. Has larger weight-bearing zone to support vaginal aspect of pubis. Pessary in position

Size A B   Inches mm Inches mm 0 2 3/4" 70 2 1/4" 57 1 2 3/4" 70 2 1/2" 63 2 3 1/16" 81 2 1/2" 63 3 3 1/8" 86 2 5/8" 67 4 3 5/8" 93 2 3/4" 70 5 3 3/4" 94 3 76 6 4" 101 3 1/8" 79 7 4 1/8" 104 3 1/4" 83 8 4 1/4" 107 3 3/8" 86 9 4 1/2" 115 3 1/2" 89

Other Common Uses of Smith, Hodge, and Risser Pessaries

DYSMENORRHEA - Where there is no other demonstrable pathology other than retroversion, a fair number of patients are relieved of dysmenorrhea by wearing a Smith or Hodge pessary.

HASTEN POSTPARTUM INVOLUTION - The pessary lifts and repositions the uterus, promotes drainage, and generally speeds involution.

INFERTILITY - Occasionally retroversion is a reason for non-conception. A pessary is helpful because it places the cervix in the seminal pool and at the same time may help to improve circulation to the ovaries and endometrium.

PROLAPSED OVARY - The elongation of the utero-ovarian ligament is often relieved with a properly fitted pessary because: (a) the weight of the ovary is reduced, and (b) there is marked improvement in the circulation.

POSTPARTUM RETROVERSION - Pessary can be used advantageously in women who had a normally positioned uterus before pregnancy and developed a retroverted uterus postpartum.

BACKACHE - In some cases, a malpositioned uterus is the cause of a backache. Patients reported a definite improvement while pessary was in place.

1. Used diagnostically to establish need for surgery.
2. Used therapeutically where surgery is contraindicated.

ABNORMAL BLEEDING is the result of many causes. In those instances in which all the standard tests are negative, bleeding frequently discontinues after the uterus is put into the proper position. Circulation is improved and normal physiology is reestablished.

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