GB2426589A

GB2426589A - Medical measuring apparatus

Info

Publication number: GB2426589A
Application number: GB0523787A
Authority: GB
Inventors: Najum Us Saqib Qureshi
Original assignee: Individual
Current assignee: Individual
Priority date: 2005-05-24
Filing date: 2005-11-23
Publication date: 2006-11-29
Anticipated expiration: 2025-11-23
Also published as: GB0510474D0; GB2426589B; GB0523787D0

Abstract

Medical measuring apparatus (10) for determining the size of a ring pessary required by a patient suffering from utero-vaginal prolapse, the apparatus comprising a rod (12) having a proximal portion (20) and a distal portion (22) which are set at an angle to each other, a graduated scale (26) marked on the rod (12), the graduated scale showing sizes of ring pessary and a marker (28) slidable along the rod (12) wherein the overall length of the rod is greater than the length of a standard female vagina.

Description

TITLE: MEDICAL MEASURING APPARATUS

DESCRIPTION The present invention relates to medical measuring apparatus for determining the size of a ring pessary required by a patient suffering from utero-vaginal prolapse. Utero-vaginal prolapse is a common gynaecological problem which most commonly affects postmenopausal women. The problem may be solved by surgical means, which in most cases means a hysterectomy operation or a repair procedure and often includes both. Alternatively, in patients where surgical treatment is not a favoured option or is contraindicated because of co-existing medical problems, a vaginal ring pessary insertion may be used for conservative management of the condition. Conventionally, the size of the ring pessary suitable for a patient is determined by a digital examination. However, this is a subjective method and its accuracy in determining the appropriate size of the ring pessary is dependent on the experience of the person conducting the digital examination. Various devices have been proposed for conducting vaginal measurements. For example, in WO 01/76477 there is described a device for measuring the length of the cervix, the dimensions of the fornix vaginae and the dilation of the cervix uteri. Various devices have also been proposed for measuring the type and degree of pelvic organ prolapse. For example, WO 03/032820 describes a vaginal speculum with removable blades. The device may be provided with a retractable calibrated blade for measuring the degree of prolapse of the cervix. In GB 2363199, there is described a device comprising an inner elongate scaled core and an outer transparent tube which has a marker ring movably positioned around the outer tube. In use, the outer tube is moved relative to the inner core until prongs on the tube are secured to tissue. The device is then removed and the ring moved along the tube until it is level with a base reference point. The measurement is taken first when a patient is lying down and repeated with the patient standing up. The difference between the two readings is indicative of the degree of prolapse. EP 428793 also describes a device comprising a plunger which moves within a cylindrical cover. The cover has a projection which permits placement of the device end to end against external genitals. The plunger is then slid into the vagina until its other end comes up against the cervix of the uterus. The patient then pushes against the plunger and the measurement is noted on a graduated scale. US 2,241,451 provides a device which is used to measure the vaginal cavity, indicating the diameter of a flexible rubber diaphragm which will be required to fit the vaginal canal. The device comprises an outer shell within which an elongate member is slidable. A flexible loop extends from the slidable member and its size is determined by the relative positions of the elongate member and the outer shell. Indicia are provided on the device to show the size of the loop. None of the above devices measure the size of ring pessary which is required to address the problem of uterovaginal prolapse. It is an object of the invention to provide apparatus for measuring the size of a ring pessary required for addressing the problem of utero-vaginal prolapse. In accordance with a first aspect of the present invention, there is provided medical measuring apparatus for determining the size of a ring pessary required by a patient suffering from utero-vaginal prolapse, the apparatus comprising an elongate member or rod having a proximal portion and a distal portion which are set at an angle to each other, a graduated scale marked on the rod, the graduated scale showing sizes of ring pessary and a marker slidable along the rod wherein the overall length of the rod is greater than the length of a standard female vagina. Since the length of the rod is greater than the length of a standard female vagina, a portion of the apparatus will remain outside the vagina during an examination. Typically, the rod may be greater than 20cm or greater than 25cm in length. The two portions of the rod may be set at an angle of about 15 degrees. The distal portion may be approximately one-quarter to one-half the length of the proximal portion. In this way, the distal portion of the apparatus may be more easily and more comfortably inserted into a patient's vagina. The markings on the graduated scale may be calibrated to give ring pessary sizes appropriate to and corresponding to measured distances between the posterior fornix of the vagina and the symphysis pubis (P-S distance). By providing markings calibrated in this way, the apparatus is simple to use to determine objectively the ring pessary size appropriate to each patient. The rod may be generally cylindrical. The marker may be lockably slidable on the rod. The distal portion of the rod may be provided with a rounded end (e.g. ball-shaped). The proximal end of the rod may be provided with a handle. The apparatus may be made from plastic. The apparatus may be provided in a clean but not necessarily sterile pack. The apparatus is preferably disposable after use. In accordance with a second aspect of the invention, there is provided a method for determining the size of a ring pessary required by a patient suffering from uterovaginal prolapse, the method comprising providing a rod having first and second portions set at an angle to each other, with the overall length of the rod being greater than the length of a standard female vagina and a graduated scale marked on the rod, inserting the rod into the vagina of a supine patient until one end of the rod abuts the patient's cervix, sliding a marker along the rod until the marker abuts the end of the patient's vagina, withdrawing the apparatus from the vagina and reading the size of ring pessary from the position of the marker along the graduated scale. Embodiments of the invention will now be described by way of example with reference to the accompanying drawings in which: Figure 1 is a schematic view of a measuring device embodying the present invention; Figure 2 is a diagrammatic illustration of the female pelvic anatomy with the measuring device of Figure 1 in situ; and Figure 3 is a more detailed illustration of a measuring device embodying the present invention. Figures 1 and 3 show medical measuring apparatus 10 embodying the present invention, which comprises an elongate member or rod 12 of circular cross section. The rod 12 has a proximal portion 20 with proximal end 30, and a distal portion 22 with distal end 32. The distal portion 22 of the rod 12 is set at a gentle angle "a" of about 15[deg] to the proximal portion 20.The proximal portion 20 has a graduated scale 26 with a marker 28 which is slidable over the graduated scale 26. The distal end 32 is rounded to avoid sharp edges, and the proximal end 30 has an enlarged head to provide improved purchase when using the apparatus 10. The graduated scale 26 is calibrated with ring pessary sizes, for example the sizes 53mm, 56mm, 59mm, 62mm, 65mm, 68mm, 71mm, 74mm, 77mm, 80mm, 85mm, 90mm, 95mm, 100mm, 105mm and 110mm. The overall length of the apparatus is approximately 25-30cm, with the distal portion 22 extending for approximately 5-lOcm. In other words, the overall length of the apparatus 10 is sufficiently greater than the standard length of a female vagina to allow a portion of the apparatus to remain outside the vagina during an examination. Figure 2 shows the female pelvic anatomy and shows the posterior fornix of the vagina and the symphysis pubis. The distance between the two is marked as the S-P distance. It is this distance which is critical in assessing the size of ring pessary needed to address the problem. The measuring apparatus of Figure 1 is used on a patient lying down in a standard position for a gynaecological examination. As shown in Figure 2, the apparatus 10 is inserted into a patient's vagina until the distal end 32 abuts the patient's posterior fornix 50. The marker 28 is then moved along the rod 12 from the proximal end 30 until it is adjacent to the patient's pubic bone 52. The marker 28 may be locked in position to resist subsequent movement, e.g. by squeezing the marker 28 to increase frictional engagement with the rod 12. The apparatus 10 is then withdrawn from the patient's vagina and the size of the ring pessary required is simply read from the position of the marker 28 on the graduated scale.

Claims

1. Medical measuring apparatus for determining the size of a ring pessary required by a patient suffering from uterovaginal prolapse, the apparatus comprising a rod having a proximal portion and a distal portion which are set at an angle to each other, a graduated scale marked on the rod, the graduated scale showing sizes of ring pessary and a marker slidable along the rod wherein the overall length of the rod is greater than the length of a standard female vagina.

2. Medical measuring apparatus according to claim 1 which is greater than 20 cm in length.

3. Medical measuring apparatus according to claim 1 or claim 2, wherein the distal and proximal portions of the rod are set at an angle of about 15 degrees.

4. Medical measuring apparatus according to any one of the preceding claims, wherein the distal portion is approximately one-quarter to one-half the length of the proximal portion.

5. Medical measuring apparatus according to any one of the preceding claims, wherein markings on the graduated scale are determined from assessing the distance between the posterior fornix of the vagina and the symphysis pubis (P-S distance).

6. Medical measuring apparatus according to any one of the preceding claims, wherein the marker is lockably slidable on the rod.

7. A method for determining the size of a ring pessary required by a patient suffering from utero-vaginal prolapse, the method comprising providing a rod having first and second portions set at an angle to each other, with the overall length of the rod being greater than the length of a standard female vagina and a graduated scale marked on the rod, inserting the rod into the vagina of a supine patient until one end of the rod abuts the patient's posterior fornix, sliding a marker along the rod until the marker abuts the end of the patient's vagina, withdrawing the apparatus from the vagina and reading the size of ring pessary from the position of the marker along the graduated scale.

8. A medical measuring device substantially as hereinbefore described with reference to and as illustrated in Figures 1 to 3.