CooperSurgical Milex Instrucciones página 6

4. Ask the patient to sit, stand and bear down slightly. If there is
no leakage, and the patient is comfortable with the pessary
in position, have her empty her bladder. A properly fitted
pessary takes up slack in redundant tissue, holding the
uterus higher in the vagina.
5. If the patient can void without difficulty, pessary remains in
position upon re-examination, and the patient is comfortable
with the pessary in place, this is a good indication that the
correct size may have been selected. Patient experience
may vary.
Note: If the patient is unable to urinate with the pessary in
position, remove it and fit her with the next smaller size. Repeat as
necessary.
6. Examine the patient while she is in the standing position
to ensure the pessary has not shifted position. The patient
should not feel the pessary once it is in position. The
pessary should not be too loose as it may turn or be expelled
and it should not be too tight as it may cause discomfort.
7. The healthcare professional should be able to sweep one
finger between the pessary and the vaginal walls. If there
is not enough space to do this, the next smaller size should
be tried. If excessive space exists, the pessary will not be
effective and may rotate or even be expelled.
8. It is sometimes necessary to refit the patient with a different
size or type of pessary after a period of time. Do not assume
that a replacement will always be the same size as the
previous one. Check the fitting to ensure continued patient
comfort and relief of symptoms. The useful life of a pessary
is limited. Examine frequently for signs of deterioration (such
as cracks or breaks in silicone outer surface). A pessary
should be replaced if damaged.
TO REMOVE
Hook one finger inside the center
of the pessary. Use the thumb and
middle finger to compress the side
of the DONUT (see Figure 3). Use
the finger of other hand to press
down on the perineum. Angle the
pessary and pull gently through the
introitus.
GELLHORN Multiple Drain
Fitting Pessary
Support for third-degree prolapse/procidentia
(Stage III or Stage IV)
Fitting pessary sizes available in kit and corresponding pessary sizes
GELLHORN (Flexible)
Fitting Kit
Replacement
Pessary Part No. Size
MXFIT0012 2-1/4"
MXFIT0013 2-1/2"
MXFIT0014 2-3/4"
MXFIT0015 3"
DESCRIPTION
The Milex GELLHORN Pessary is a medical device made from
®
silicone that is inserted into the vagina to function as a supportive
structure of the uterus, bladder and/or rectum.
Figure 3
Product
Part No. inches
MXPGE2-1/4 2-1/4"
MXPGE2-1/2 2-1/2"
MXPGE2-3/4 2-3/4"
MXPGE3- 3"
WARNINGS
• Do not leave pessaries in place for long periods of time, as
serious complications can occur which may require surgical
intervention.
• Do not use these pessaries on a patient with a known silicone
allergy.
• Chemicals in various vaginal preparations can interact with
the pessary material, resulting in discoloration or deterioration
of the pessary. TRIMO-SAN™* does not interact with the
pessary material. Use only TRIMO-SAN*. Other materials
have not been tested for compatibility.
INDICATIONS FOR USE
For effective support of third-degree prolapse or procidentia.
The cervix rests behind the flat base of the pessary and only
the stem shows in the vaginal entrance when the patient does a
Valsalva maneuver. The GELLHORN pessary requires a relatively
capacious vagina and an intact perineum.
CONTRAINDICATIONS
• The presence of pelvic infections and/or lacerations
• A noncompliant patient
• Endometriosis
• Pregnant patient
• Sexually active patient
INSTRUCTIONS
Review these instructions with the patient to establish use regimen.
1. Wear dry gloves. When necessary, lubricate only the entering
end of the pessary with TRIMO-
SAN* or equivalent vaginal jelly.
Hold the pessary as shown in
Figure 1.
2. Use one finger to depress the
perineum.
3. Guide the pessary, inserting it
edgewise almost parallel to the
introitus (see Figure 1), avoiding the
urethral opening while the perineum
is strongly pushed downward.
Use a corkscrew motion while
introducing the GELLHORN into
the vagina.
4. Once the large flat disc is
past the introitus, push the
pessary upward until only
the end of the stem shows
in the vaginal entrance. The
cervix rests behind the flat
disc (see Figure 2).
5. Have the patient sit, stand
and bear down. Examine
the patient while she is
in the standing position
to ensure the pessary has not shifted position. The patient
should not feel the pessary once it is in position. The pessary
mm
should not be too loose as it may turn or be expelled and it
should not be too tight as it may cause discomfort.
57 mm
6. The healthcare professional should be able to sweep one
64 mm
finger between the pessary and vaginal walls. If there is not
enough space to do this, the next smaller size should be tried.
70 mm
If excessive space exists, the pessary will not be effective and
76 mm
may rotate or even be expelled.
7. It may be necessary to refit the patient with a different size
or type of pessary after a period of time. Do not assume that
a replacement will always be the same size as the previous
one. Check the fitting to ensure continued patient comfort
and relief of symptoms. The useful life of a pessary is limited.
* TRIMO-SAN is not sold outside the USA.
6
Stem
Disc
Figure 1
Figure 2