Hegar dilators
Hegar dilatorsaredilatorsused to treatvaginismusand inducecervicaldilation, and forinflatable penile implantprocedures, though for penile implants it has been shown that outcomes are betterwithoutdilation.[1][2] [3][4]
Description
[edit]Hegar dilators were developed and introduced byAlfred Hegarin 1879 originally for use in the field ofgynecology.[5]Typically, dilators are a set of metal rods of increasing diameters, from a few millimeters up to 26 millimeters. The rods are round, slightly curved, and have a conal tip. Some sets have conal tips at both ends, while others have one end flattened for easy handling.[6]Hegar dilators are typically marked with a Hegar number that is equivalent to its size in millimeters (e.g., a Hegar size 8 is 8 mm thick). Commercially available Hegar dilators are commonly sold in sets of 8, 10, or 14 individual rods.[7]Each set includes a range of sizes, popularly from 3 mm to 17 mm for single-ended dilators or 3 mm / 4 mm to 17 mm / 18 mm for double-ended dilators, though configurations with sizes anywhere from 1 mm to 26 mm do exist.[8][9]
Use in the treatment of vaginismus
[edit]Hegar dilators are used to treatvaginismus,also known as genito-pelvic pain disorder.[4][3]Patients with vaginismus use Hegar dilators of gradually increasing size, potentially followed by penetration by their partner.[10]They have also found application in the management ofhymenalstenosis.[11][12]
Cervical procedure use
[edit]Hegar dilators are used to inducecervical dilationin order to gain entry to the interior of theuterus.
During the process of dilation, thecervixmay have to be stabilized with atenaculum,and then the dilators are slowly entered into the cervical canal with a lubricant, starting with a thin, low Hegar number rod and progressing gradually to larger numbers.[13]The dilators can also be used to sound the uterus.
Laminariarods have also been used to open up the cervix but work slowly as they increase size by absorbing water.
Non-gynecological uses
[edit]Typical non-gynecological uses include dilating a stenotic percutaneous gastrostomy stoma, anal dilation and urethral dilation in the case of stricture or stenosis.
Penile implant procedure use
[edit]Hegar dilators (commonly, sizes 11 and 12) have been used during the insertion of two intracorporal cylinders into thecorpus cavernosum penisduringpenile implantprocedures, but it has been shown that outcomes are betterwithoutthis dilation, which destroys erectile tissue.[1][2]These cylinders are inflated and deflated by a pump that moves sterile saline under pressure between a holding reservoir and the cylinders, inflating or deflating an erection of the penis.[14]
References
[edit]- ^abZaazaa, Adham; Mostafa, Taylor (14 February 2019)."Spontaneous Penile Tumescence by Sparing Cavernous Tissue in the Course of Malleable Penile Prosthesis Implantation".The Journal of Sexual Medicine.16(3): 474–478.doi:10.1016/j.jsxm.2019.01.012.Retrieved14 January2024.
- ^abMoncada, Ignacio; Juan Ignacio, Martínez-Salamanca; José, Jara; Ramiro, Cabello; Mercedes, Moralejo; Carlos, Hernández (1 Mar 2010)."Inflatable Penile Prosthesis Implantation Without Corporeal Dilation: A Cavernous Tissue Sparing Technique".Journal of Urology.183(3): 1123–1126.doi:10.1016/j.juro.2009.11.048.Retrieved14 January2024.
- ^abThe Urologic and Cutaneous Review, Volume 52.Urologic & Cutaneous Press. 1948. p. 129.
- ^abDoleys, Daniel (6 December 2012).Behavioral Medicine.Springer Science & Business Media. p. 377.ISBN9781468440706.
- ^M Tschoudowski:De la dilatation du canal cervical (d’après Hegar).(1879) Arch Tocol 6: 737–755
- ^"Medgyn Hegar Single Ended Cervical Dilator".
- ^"Premium Instruments, 10 Pcs Hegar Uterine Dilators Gynecology Double Ended Surgical Instruments".Amazon.Retrieved2021-12-22.
- ^"Cooper Surgical, Hegar Cervical Dilators".
- ^"Medsor Impex, Hegar dilator set (8 pcs)".
- ^Fuchs K (1980). "Therapy of vaginismus by hypnotic desensitization".American Journal of Obstetrics & Gynecology.137(1): 1–7.doi:10.1016/0002-9378(80)90376-2.PMID6102843.
- ^Segal TR, Fried WB, Krim EY, Parikh D, Rosenfeld DL (2015). "Treatment of microperforate hymen with serial dilation: a novel approach".Journal of Pediatric and Adolescent Gynecology.28(2): e21–2.doi:10.1016/j.jpag.2014.06.001.PMID25444056.
- ^Katz, Ditza (2020)."Dilators, Lidocaine, vaginismus treatment | Women's Therapy Center".Retrieved2021-01-21.
- ^Hellman LM, Pritchard JA.Williams Obstetrics, 14th edition.Appleton Century Croft, 1971. p. 1089f.
- ^Al-Shaiji, TariqF; Al-Enezi, Ahmad; Al-Khadhari, Sulaiman (2011)."Three-piece inflatable penile prosthesis: Surgical techniques and pitfalls".Journal of Surgical Technique and Case Report.3(2): 76–83.doi:10.4103/2006-8808.92798.PMC3296438.PMID22413049.