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Re: Vaginal Pessaries From: Darach Corcoran (djdc@iol.ie) Fri Apr 12 17:32:20 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Darach Corcoran: "Symphysiotomy" Previous message: R. Daniel Braun: "Re: US MANAGED CARE" Maybe in reply to: Paul J Scott: "Vaginal Pessaries" Mats Bergstrom, MD writes:- >The traditional approach here is an examination with cleaning of the >ring every three months, but the intervals seem to have leangthened >over the last decade, even to 1 year, without anybody discussing it >much. My own experience is, that if the vaginal wall is kept healthy >with estriol (or stronger estrogens) and there's no sign of damage >after the first three months and the woman continue to be free of symptoms, >then the device could possibly be left in situ without check-ups for ever. I think this is unwise, as I have seen decubitus ulcers caused by ring pessaries left in situ for long periods (over 1 year or more) which have been malignant on biopsy. Decubitus ulcers are a not infrequent complication even with regular three monthly changes. I do not think pessaries should any longer be cleaned and re-used, as the surfaces become rough and I think increase the risk of ulceration. We repalce them every three months with a new one. I do not think pessaries should be encouraged as a treatment, except in clearly defined circumstances where a surgical repair cannot be done, or the patient declines surgery Kind regards, Darach Corcoran ____________________________________________________ Dr. D. J. D. Corcoran KM FRCOG ____________________________________________________ Consultant Obstetrician and Gynaecologist Western Health Board Mayo General Hospital, Castlebar, Co. Mayo, Ireland The Old Rectory Tel:- +353 94 24333 Spencer Street Fax:- +353 94 23652 Castlebar Cellular:- +353 88 559398 County Mayo Ireland Next message: Darach Corcoran: "Symphysiotomy" Previous message: R. Daniel Braun: "Re: US MANAGED CARE" Maybe in reply to: Paul J Scott: "Vaginal Pessaries"

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