Hegar dilators are dilators used to treat vaginismus and induce cervical dilation, and for inflatable penile implant procedures, though for penile implants it has been shown that outcomes are better without dilation. [1] [2] [3] [4]
Hegar dilators are dilators used to treat vaginismus and induce cervical dilation, and for inflatable penile implant procedures, though for penile implants it has been shown that outcomes are better without dilation. [1] [2] [3] [4]
Hegar dilators were developed and introduced by Alfred Hegar in 1879 originally for use in the field of gynecology. [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]
Hegar dilators are used to treat vaginismus, 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 of hymenal stenosis. [11] [12]
Hegar dilators are used to induce cervical dilation in order to gain entry to the interior of the uterus.
During the process of dilation, the cervix may have to be stabilized with a tenaculum, 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.
Laminaria rods have also been used to open up the cervix but work slowly as they increase size by absorbing water.
Typical non-gynecological uses include dilating a stenotic percutaneous gastrostomy stoma, anal dilation and urethral dilation in the case of stricture or stenosis.
Hegar dilators (commonly, sizes 11 and 12) have been used during the insertion of two intracorporal cylinders into the corpus cavernosum penis during penile implant procedures, but it has been shown that outcomes are better without this 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]
The cervix or cervix uteri is the lower part of the uterus (womb) in the female reproductive system of most mammals, including humans. The cervix is usually 2 to 3 cm long and roughly cylindrical in shape, which changes during pregnancy. The narrow, central cervical canal runs along its entire length, connecting the uterine cavity and the lumen of the vagina. The opening into the uterus is called the internal os, and the opening into the vagina is called the external os. The lower part of the cervix, known as the vaginal portion of the cervix, bulges into the top of the vagina. The human cervix has been documented anatomically since at least the time of Hippocrates, over 2,000 years ago.
Dilationand curettage (D&C) refers to the dilation of the cervix and surgical removal of part of the lining of the uterus or contents of the uterus by scraping and scooping (curettage). It is a gynecologic procedure used for diagnostic and therapeutic purposes, and is the most commonly used method for first-trimester miscarriage or abortion.
The uterus or womb is the organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic and fetal development of one or more embryos until birth. The uterus is a hormone-responsive sex organ that contains glands in its lining that secrete uterine milk for embryonic nourishment.
Phalloplasty is the construction or reconstruction of a penis or the artificial modification of the penis by surgery. The term is also occasionally used to refer to penis enlargement.
Gender-affirming surgery for female-to-male transgender people includes a variety of surgical procedures that alter anatomical traits to provide physical traits more comfortable to the trans man's male identity and functioning.
Vacuum or suction aspiration is a procedure that uses a vacuum source to remove an embryo or fetus through the cervix. The procedure is performed to induce abortion, as a treatment for incomplete spontaneous abortion or retained fetal and placental tissue, or to obtain a sample of uterine lining. It is generally safe, and serious complications rarely occur.
Dilation and evacuation (D&E) is the dilation of the cervix and surgical evacuation of the uterus after the first trimester of pregnancy. It is a method of abortion as well as a common procedure used after miscarriage to remove all pregnancy tissue.
Cervical effacement or cervical ripening refers to the thinning and shortening of the cervix. This process occurs during labor to prepare the cervix for dilation to allow the fetus to pass through the vagina. While this a normal, physiological process that occurs at the later end of pregnancy, it can also be induced through medications and procedures.
Cervical weakness, also called cervical incompetence or cervical insufficiency, is a medical condition of pregnancy in which the cervix begins to dilate (widen) and efface (thin) before the pregnancy has reached term. Definitions of cervical weakness vary, but one that is frequently used is the inability of the uterine cervix to retain a pregnancy in the absence of the signs and symptoms of clinical contractions, or labor, or both in the second trimester. Cervical weakness may cause miscarriage or preterm birth during the second and third trimesters. It has been estimated that cervical insufficiency complicates about 1% of pregnancies, and that it is a cause in about 8% of women with second trimester recurrent miscarriages.
Cervical stenosis means that the opening in the cervix is more narrow than is typical. In some cases, the endocervical canal may be completely closed. A stenosis is any passage in the body that is more narrow than it should typically be.
A vaginal dilator is an instrument used to gently stretch the vagina. They are used when the vagina has become narrowed, such as after brachytherapy for gynecologic cancers, and as therapy for vaginismus and other forms of dyspareunia.
Hematocolpos is a medical condition in which the vagina is pooled with menstrual blood due to multiple factors leading to the blockage of menstrual blood flow. The medical definition of hematocolpos is 'an accumulation of blood within the vagina'. It is often caused by the combination of menstruation with an imperforate hymen. It is sometimes seen in Robinow syndrome, uterus didelphys, or other vaginal anomalies.
A penile implant is an implanted device intended for the treatment of erectile dysfunction, Peyronie's disease, ischemic priapism, deformity and any traumatic injury of the penis, and for phalloplasty or metoidioplasty, including in gender-affirming surgery. Men also opt for penile implants for aesthetic purposes. Men's satisfaction and sexual function is influenced by discomfort over genital size which leads to seek surgical and non-surgical solutions for penis alteration. Although there are many distinct types of implants, most fall into one of two categories: malleable and inflatable transplants.
Vaginal hypoplasia is the underdevelopment or incomplete development of the vagina. It is a birth defect or congenital abnormality of the female genitourinary system.
The endometrial biopsy is a medical procedure that involves taking a tissue sample of the lining of the uterus. The tissue subsequently undergoes a histologic evaluation which aids the physician in forming a diagnosis.
Hematometra is a medical condition involving collection or retention of blood in the uterus. It is most commonly caused by an imperforate hymen or a transverse vaginal septum.
Osmotic dilators are medical implements used to dilate the uterine cervix by swelling as they absorb fluid from surrounding tissue. They may be composed of natural or synthetic materials. A laminaria stick or tent is a thin rod made of the stems of dried Laminaria, a genus of kelp. Laminaria sticks can be generated from Laminaria japonica and Laminaria digitata. Synthetic osmotic dilators are commonly referred to by their brand names, such as Dilapan. Dilapan-S are composed of polyacrylonitrile, a plastic polymer. The hygroscopic nature of the polymer causes the dilator to absorb fluid and expand.
Genital trauma is trauma to the genitalia.
Vaginal stenosis is an abnormal condition in which the vagina becomes narrower and shorter due to the formation of fibrous tissue. Vaginal stenosis can contribute to sexual dysfunction, dyspareunia and make pelvic exams difficult and painful. The lining of the vagina may also be thinner and drier and contain scar tissue. This condition can result in pain during sexual intercourse or a pelvic exam. Vaginal stenosis is often caused by radiation therapy to the pelvis, an episiotomy, or other forms of surgical procedures. Chemotherapy can also increase the likelihood of developing vaginal stenosis. Vaginal stenosis can also result from genital reconstructive surgery in people with congenital adrenal hyperplasia.
Penile implants may be employed to treat erectile dysfunction or urinary troubles after a spinal cord injury.