NL2025355B1

NL2025355B1 - Pessary

Info

Publication number: NL2025355B1
Application number: NL2025355A
Authority: NL
Inventors: Willem Alexander Huisman Tjeerd
Original assignee: Perfect Pessary B V
Priority date: 2020-04-16
Filing date: 2020-04-16
Publication date: 2021-10-26

Abstract

The invention relates to a pessary comprising a main body that merges into a distal support body, wherein the main body and the distal support body are in series in an insert direction of the pessary and define an elongated 5 shape of the pessary in the insert direction, wherein the main body comprises a convex front outer surface and a convex back outer surface that are opposite to each other, and a left outer surface and a right outer surface that are opposite to each other and that extend between the convex 10 front outer surface and the convex back outer surface, and a left suction chamber that merges into the left outer surface and a right suction chamber that merges into the right outer surface.

Description

P136256NL00 Pessary

BACKGROUND The invention relates to a pessary. A pessary is for example used for the treatment of prolapse of pelvic organs (POP) or for the mitigation of the adverse effects thereof. A known pessary has a cubical shape with rounded edges and a suction chamber in each of the six sides, The pessary is placed in a female vagina to support the uterus at the cervix.

SUMMARY OF THE INVENTION A disadvantage of the known pessary is that it has shortcomings in its holding capacity whereby it regularly needs to be replaced by a gynecologist, or by a skilled doctor or nurse. This is uncomfortable for the user.

It is an object of the present invention to provide a pessary that combines a long lasting holding capacity with sufficient wearing comfort.

The invention provides a pessary comprising a main body that merges into a distal support body, wherein the main body and the distal support body are in series in an insert direction of the pessary and define an elongated shape of the pessary in the insert direction, wherein the main body comprises a convex front outer surface and a convex back outer surface that are opposite to each other, wherein the convex front outer surface and the convex back outer surface have opposite apexes that define a first width of the pessary as from which the pessary tapers along the convex front outer surface and the convex back outer surface towards its distal end and its proximal end, wherein the main body comprises a left outer surface and a right outer surface that are opposite to each other, that extend between the convex front outer surface and the convex back outer surface, and that define a second width of the pessary orthogonal to the first width, wherein the main body comprises a left suction chamber and a right suction chamber that are opposite to each other, that are separate from each other, and that are recessed in the main body, wherein the left suction chamber is bound by a left inner surface that merges into the left outer surface along a left upper edge that defines an opening to the left suction chamber, and wherein the right suction chamber is bound by & right inner surface that merges into the right outer surface along a right upper edge that defines an opening to the right suction chamber.

The pessary according to the invention comprises the opposite convex front outer surface and the convex back outer surface along which it tapers towards its distal end and its proximal end. The left suction chamber and the right suction chamber extend between the convex outer surfaces, with the upper edges preferably transverse thereto. The suction chambers can receive and confine the tissue of the vagina that extends around the pessary between the opposite apexes. It has been found that this ensures a long lasting holding power for the pessary to support the uterus at the cervix. The suction can be released by rotating the pessary around its longitudinal axis, whereby the confined tissue is released from the suction chambers and comes in contact with the convex outer surfaces.

In an embodiment the left upper edge and the right upper edge are elliptical upper edges having the short sides opposite to each other in the insert direction.

The elliptical upper edges extend with the short sides opposite to each other in the insert direction, whereby the tissue of the vagina is mainly stretched transverse to the elongated direction. This is comfortable for the user.

In an embodiment thereof the elliptical left upper edge and the elliptical right upper edge extend over at least half of their long sides at a constant distance to the nearest convex front outer surface or convex back outer surface.

In an embodiment the left outer surface and the right outer surface are straight outer surfaces that extend parallel to each other.

In an embodiment the convex front outer surface, the left outer surface, the convex back outer surface and the right outer surface are in a cross section orthogonal to the insert direction in a mutual rectangular configuration.

In an embodiment the distal support body comprises a distal top support surface that extends transverse to the insert direction of the pessary to come in contact with the cervix or the vaginal top.

In an embodiment thereof the distal top support surface is a straight distal top support surface so as to abut the cervix or the vaginal top under the same angle over at least a mayor part of the top surface.

In an embodiment the distal support body comprises a convex front support surface that merges into the convex front outer surface of the main body, and a convex back support surface opposite to the front support surface that merges into the convex back outer surface of the main body, wherein the front support surface and the back support surface define between said mergers a third width of the pessary. The front support surface, the back support surface and the near parts or the continuations of the left outer surface and the right outer surface may define a rectangular or square cross section of the distal support body.

In an embodiment the left inner surface and the right inner surface respectively comprise a left bottom surface and a right bottom surface that are straight and that extend parallel and spaced apart from each other in the main body.

In an embodiment the left inner surface and the right inner surface respectively comprise a left inner side surface and a right inner side surface that extend under an oblique angle with respect to the respective adjacent left outer surface and right outer surface.

In an embodiment thereof the oblique angle is constant along the circumference of the respective adjacent left upper edge and right upper edge.

In an embodiment the main body comprises a back suction chamber that is recessed in the main body, wherein the back suction chamber is bound by a back inner surface that merges into the convex back outer surface along a back upper edge that defines an opening to the back suction chamber. The back suction chamber can be directed to the rectum while the left suction chamber and the right suction chamber are directed to the coxa. The back suction can provide additional holding power for the pessary to support the uterus at the cervix.

In an embodiment the back upper edge is an elliptical upper edge having the short sides opposite to each other in the insert direction. The elliptical upper edges extend with the short sides opposite to each other in the insert direction, whereby the tissue of the vagina is mainly stretched transverse to the elongated direction.

This is comfortable for the user.

In an embodiment the pessary comprises an urethral knob that projects from the convex front outer surface. The urethral knob applies some pressure against the urethra for the treatment of incontinence or for the mitigation of the adverse effects thereof.

In an embodiment thereof the urethral knob extends at the lower half of the main body that is at the opposite side of the distal support body.

In an embodiment the pessary comprises a handling section for manual handling of the pessary, wherein the handling section comprises a finger grip that merges into 5 the main body. The finger grip provides control when inserting the pessary. This can be performed by a specialist or by the patient herself after some exercise.

In an embodiment thereof the finger grip has a bow that merges into the main body, wherein the bow bounds a finger channel for insertion of a finger or thumb. By inserting a finger or thump in the finger channel, the pessary can precisely follow the movements of the hand when it is pushed and pulled in the insert direction or rotated around its longitudinal axis by the specialist or by the patient herself.

In an embodiment thereof the {finger channel extends orthogonal to the insert direction, whereby it is easy to rotate the pessary around its longitudinal axis in order to release it.

In a compact embodiment the finger channel extends at least partly in between the left upper edge and the right upper edge of the suction chambers. In this embodiment the finger channel is recessed towards and partly between the suction chambers, whereby the length of the suction chambers can be optimized in the insertion direction.

In an embodiment the main body and the support body together form a single unity.

In an embodiment the main body, the support body and the handling section together form a single unity.

In an embodiment the pessary has a first symmetry plane that extends between the left suction chamber and the right suction chamber.

In an embodiment the pessary has a second symmetry plane for the distal support body, the left suction chamber and the right suction chamber, that extends between the convex front outer surface and the convex back outer surface.

In a particular embodiment thereof the first symmetry plane and the second symmetry plane are orthogonal to each other.

In an embodiment the insert direction is parallel to the secant line of the first symmetry plane and the second symmetry plane.

In an embodiment the convex front outer surface, the convex back outer surface, the left suction chamber and the right suction chamber have a third symmetry plane that extends through the apexes of the convex front outer surface and the convex back outer surface.

In an embodiment thereof the third symmetry plane is orthogonal to the first symmetry plane and the second symmetry plane.

In an embodiment the first width is between 30 millimeters and 60 millimeters.

In an embodiment the first width is 45-60%, preferably 50-55% of the length of the pessary in the insert direction.

In an embodiment the second width is between 20 millimeters and 50 millimeters.

In an embodiment the second width is 30-45%, preferably 35-40% of the length of the pessary in the insert direction.

In an embodiment the second width is 70-80%, preferably 72-76% of the first width.

In an embodiment the first width is larger than the second width.

In an embodiment the third width is between 20 millimeters and 50 millimeters.

In an embodiment the third width is 30-45%, preferably 35-40% of the length of the pessary in the insert direction.

In an embodiment the third width is 70-80%, preferably 72-76% of the first width.

In an embodiment the pessary is manufactured with or of a flexible, shape retaining material, whereby the pessary can be comfortable to wear and can be easily inserted in the vagina.

In a particular embodiment thereof the pessary is manufactured with or of silicone or a rubber like material.

The pessary may in particular be for use in the treatment of prolapse of pelvic organs (POP) or for diminishing the adverse effects thereof.

The various aspects and features described and shown in the specification can be applied, individually, wherever possible. These individual aspects, in particular the aspects and features described in the attached dependent claims, can be made subject of divisional patent applications.

BRIEF DESCRIPTION OF THE DRAWINGS The invention will be elucidated on the basis of exemplary embodiments shown in the attached drawings, in which: Figures 1A and 1B show an isometric front view and an isometric rear view of a pessary according to a first embodiment of the invention; Figures 2A-2G are a left side view, a front view, a rear view, a top view, a bottom view, a longitudinal section and a cross section of the pessary according to figures 1A and 1B; Figure 3 shows the pessary of figures 1A-2G positioned in a human female body for the treatment of prolapse of pelvic organs.

Figures 4A and 4B show an isometric front view and an isometric rear view of a pessary according to a second embodiment of the invention; Figures 5A-5E are a side view, a front view, a rear view, a top view, and a bottom view of the pessary according to figures 4A and 4B; and

Figure 6 shows the pessary of {figures 5A-2E positioned in a human female body for a combined treatment of prolapse of pelvic organs and incontinence.

DETAILED DESCRIPTION OF THE INVENTION Figures 1A-2G show a pessary 1 according to a first embodiment of the invention. The pessary 1 is for medical purposes, in particular for the treatment of prolapse of pelvic organs (POP) or for the mitigation of the adverse effects thereof. The pessary 1 has a first center line S in the elongated direction of the pessary 1 and an insert direction P in the direction of the first center line S. The pessary 1 has a first symmetry plane Vl and a second symmetry plane V2 that are orthogonal to each other, wherein the first center line S is the secant of the first symmetry plane V1 and the second symmetry plane V2. The pessary 1 has a third symmetry plane V3 for some parts of the pessary 1 as described hereafter, that is orthogonal to the first symmetry plane V1 and the second symmetry plane V2. Figure 3 shows some of the pelvic organs of a human female body 600, in particular the rectum 601, the vulva 602, the vagina 603, the uterus 604 with its cervix 605 ending in the vagina 603, and the urine bladder 606 that downwardly merges into the urethra 607. The pessary 1 is positioned in the vagina 603 by manual insertion in the insert direction P from the vulva 602. In the following description of the pessary 1, the terms “left”, “right”, “front”, “back” and “top” are relative terms solely to identify the different parts of the pessary, and these terms are not intended to limit the scope of protection of the patent. These relative terms are related to the position of the parts of the pessary 1 with respect to the female human body 600 when the pessary 1 has been inserted in the vagina 603.

As shown in figures 1A-2G, the pessary 1 comprises a central main body 2 having a generally elongated shape in the direction of the first center line S. The main body 2 has a convex front outer surface 4 and a convex back outer surface 5 that are fluently convex in the direction of the first center line S and that have tangents orthogonal to the first symmetry plane V1. The convex front outer surface 4 and the convex back outer surface 5 are symmetrical with respect to the first symmetry plane Vl, the second symmetry plane V2 and the third symmetry plane V3. The convex front outer surface 4 and the convex back outer surface 5 define between their apexes the largest width Wl of the main body 2 orthogonal to the second symmetry plane V2 and fluently taper as from the apexes in both directions of the first center line S.

The main body 2 comprises a left outer surface 10 and a right outer surface 11 that extend parallel to the first symmetry plane Vl and that are symmetrical with respect Lo the first symmetry plane Vl. The left outer surface 10 and the right outer surface 11 define the largest width W2 of the main body 2 orthogonal to the first symmetry plane V1. The left outer surface 10 and the right outer surface 11 merge via toroidal convex outer surfaces 13 into the convex front outer surface 4 and the convex back outer surface 5.

The main body 2 comprises a left suction chamber 20 and a right suction chamber 21 that are open towards the left outer surface 10 and the right outer surface 11, respectively. The left suction chamber 20 and the right suction chamber 21 are symmetrical with respect to the first symmetry plane Vl, the second symmetry plane VZ and the third symmetry plane V3. The left suction chamber 20 and the right suction chamber 21 have a respective left elliptical upper edge 22 and a right elliptical upper edge 23 along which they merge into the left outer surface 10 and the right outer surface 11, respectively. The elliptical upper edges 22, 23 have their short sides opposite to each other in the insert direction P. The left suction chamber 20 and the right suction chamber 21 have a respective straight left inner bottom surface 24 and a straight right inner bottom surface 25 that extend parallel to the first symmetry plane V1. The inner bottom surfaces 24, 25 have an elliptical circumference having in a projection orthogonal to the first symmetry plane V1 the same shape as the elliptical upper edges 22, 23 but that is smaller than the elliptical upper edges 22, 23 over a constant distance along the entire circumference. As best shown in figures 1A, 1B and 1G the left suction chamber 20 and the right suction chamber 21 have a respective left inner side surface 26 and a right inner side surface 27 along the elliptical upper edges 22, 23 that extends along the entire circumference on notional straight lines Q. These notional straight lines Q are along the entire circumference under a constant angle a of 60-70 degrees with respect to the first symmetry plane V1 or with respect to the adjacent respective left outer surface 10 or right outer surface 11. The left inner side surface 26 and the right inner side surface 27 merge via a respective left toroidal concave inner surface 28 and a right toroidal concave inner surface 29 fluently into the respective left inner bottom surface 24 and right inner bottom surface 25. The left elliptical upper edge 22 and the right elliptical upper edge 23 may be toroidal convex surfaces having a radius that is smaller than the radius of the toroidal concave inner surfaces 28, 29. As indicated in figure ZA the walls of the main body 2 as defined between the inner side surfaces 26, 27 and the nearest convex front outer surface 4 or the convex back outer surface 5 has at a constant distance with respect to the left side surface 10 or right side surface 11 a constant thickness T along the mayor part of the long sides of the circumference of the elliptical upper edges 22, 23.

The main body 2 comprises a back suction chamber 60 that is open towards the back outer surface 5. The back suction chamber 60 is symmetrical with respect to the first symmetry plane V1 and the third symmetry plane V3. The back suction chamber 60 has a back elliptical upper edge 61 along which it merges into the back outer surface 5. The elliptical upper edge 61 has its short sides opposite to each other in the insert direction P. The back suction chamber 60 has a back inner bottom surface 64 that has in the first symmetry plane Wl a curvature that follows the curvature of the back outer surface 5 in the projection orthogonal to the first symmetry plane Wl.

As best shown in figure 2G the back suction chamber 60 has a back inner side surface 62 along the elliptical upper edge 61 that extends along the entire circumference on notional straight lines R. These notional straight lines R extend in the third symmetry plane V3 under a constant angle B of 40-60 degrees with respect to the first symmetry plane V1. The back inner side surface 62 merges via a back toroidal concave inner surface 63 fluently into the back inner bottom surface 64, The back elliptical upper edge 61 may be a toroidal convex surface having a radius that is smaller than the radius of the toroidal concave inner surface 63.

The pessary 1 comprises a distal support body 30 having a straight top support surface 31 that extends orthogonal to the first center line S. As best shown in figure 2D, the support body 30 has a generally rectangular circumference in a notional cross section orthogonal to the first center line S. The support body 30 has a convex front outer surface 33 that fluently merges via a straight outer surface 32 into the top support surface 30 and that fluently merges into the convex front outer surface 4 of the main body 2. The support body 30 has a convex back support surface 35 that fluently merges into the top support surface 31 and that fluently merges via a straight back outer surface 34 into the convex back outer surface 5 of the main body 2. The convex front support surface 33 and the convex back support surface 35 of the support body 30 have the same radius. The top support surface 31 merges via a respective left convex side support surface 36 and a right convex side support surface 37, that are opposite to each other, into the respective left outer surface 10 and the right outer surface 11 of the main body 2, wherein the radius of the left convex side support surface 36 and the right convex side support surface 37 of the support body 30 is smaller than the radius of the convex front support surface 33 and the convex back support surface 35 of the support body 30. The distal support body 30 defines a third width W3 in the direction orthogonal to the second symmetry plane V2 of the pessary 1 between the mergers of the convex front support surface 33 and the convex back support surface 35 into the straight front outer surface 32 and the straight back outer surface 34 of the main body 2.

The pessary 1 comprises a proximal handling section 50 for manual handling of the pessary 1. The handling section 50 comprises a finger grip 51 having a bow 52 that merges into the main body 2 at the long axes of the elliptical upper edges 22, 23 of the left suction chamber 20 and the right suction chamber 21. The bow 52 bounds a finger channel 53 having at least along the bow 52 a cylindrical cross section or egg-shaped cross section with a second center line C orthogonal to and extending through the first center line S and that has an inner width W4 that allows partial insertion of the end of a finger or a thumb. The finger channel 53 has an insert direction D for a finger, such as the index finger, and/or thumb, that is orthogonal to the first center line S, As best shown in figures 1A and 2F, the finger channel 53 extends in a projection orthogonal to the first symmetry plane V1 at least partly recessed under the lower short sides of the elliptical upper edges 22, 23 of the left suction chamber 20 and the right suction chamber 21, whereby the pessary 1 when it is fully inserted in the vagina 603 can be gripped between a finger and thumb while the suction chambers 20, 21 can be large enough to provide sufficient holding force along a mayor part of the length of the pessary 1 caused by suction against the tissue of the vagina 603.

The pessary 1 is made of a flexible material that is both elastic and form stable, such as a silicon, a rubber or a rubber-like material.

As shown in figure 3, the pessary 1 is positioned in the vagina 603 by manual insertion in the insert direction P from the vulva 602 as shown in figure 6. The pessary 1 is thereby handled by insertion of the ends of a finger and a thumb in the finger channel 53. The top support surface 31 of the inserted pessary 1 is finally positioned against the cervix 605 and/or the top of the vagina 603 to support it. In this position the left suction chamber 20 and the right suction chamber 21 are outwardly facing the coxa, and the back suction chamber 60 faces the rectum 601. The tissue of the vagina 603 party enters the suction chambers 20, 21, 60 where it gets enclosed due to escape of air out of the space between the suction chambers 20, 21, 60 and the tissue of the vagina 603. This enclosure is maintained and even improves over the time when wearing the pessary 1. The pessary 1 can easily be removed from the vagina 603 by first rotating it manually over a quarter of a turn around the first center line S, whereby the enclosed tissue of the vagina 603 is locally released from the suction chambers 20, 21, 60 and abuts the adjacent front outer surface 4 and back outer surface 5 of the main body.

Figures 4A-5E show a pessary 101 according to a second embodiment of the invention. Features that correspond with the first embodiment are provided with the same reference numbers. Only the additional parts are described hereafter.

The pessary 101 comprises at the front side, or opposite to the side of the back suction chamber 60, an urethral knob 170 that projects from the main body 2. The urethral knob 170 extends in the quadrant that is defined by the second symmetry plane V2 and the third symmetry plane V3 of the main body 2 and in which the handling section 50 is located.

The urethral knob 170 projects from the convex front outer surface 5. The urethral knob 170 is symmetrical in the first symmetry plane Vl.

In the projecting direction towards the distal end, the urethral knob 170 extends under an angle vy of 60-75 degrees, preferably 65-70 degrees to the second symmetry plane V2. The urethral knob 170 comprises a convex upper outer surface 171 at the side of the support body 30 and a convex lower outer surface 172 at the side of the handling section 50. The convex upper outer surface 171 and the convex lower outer surface 172 merge into each other to form the distal end of the urethral knob 170, or they merge into a front support surface 173 that forms the distal end of the urethral knob 170. The urethral knob 170 has a second length LZ between the convex front outer surface 5 and the distal end.

Figure 6 shows the pessary 101 as positioned in the vagina 603. In this position, the top support surface 31 is finally positioned against the cervix 605 and/or the top of the vagina 603 to support it in the same way as the pessary 1 according to the first embodiment.

The urethral knob 170 applies some pressure against the urethra 603 for the treatment of incontinence or for the mitigation of the adverse effects thereof.

The pessaries 1, 101 according to the first embodiment and the second embodiment have a length Ll along the first center line S between 65 millimeters and 110 millimeters.

The first width Wl is between 30 millimeters and 60 millimeters.

The second width W2 is between 20 mm and 50 mm.

The third width W3 is between 20 mm and 50 mm and is preferably equal to the second width W2. The finger channel 53 has a width W4 between 15 millimeters and 25 millimeters.

The first width Wl is 45-60%, preferably 50- 55% of the length Ll.

The second width W2 and the third width W3 are 30-45%, preferably 35-40% of the length Ll.

The second width W2 and the third width W3 are 70-80%, preferably 72-76% of the first width Wl.

In the pessary 101 according to the second embodiment, the second length L2 is 10-30% of the first length Ll.

It is to be understood that the above description is included to illustrate the operation of the preferred embodiments and is not meant to limit the scope of the invention.

From the above discussion, many variations will be apparent to one skilled in the art that would yet be encompassed by the scope of the present invention.

Claims

CONCLUSIONS

A diaphragm comprising a main body which transitions into a distal support body, wherein the main body and the distal support body are in series in an insertion direction of the diaphragm and define an elongate shape of the diaphragm in the insertion direction, the main body having a convex front outer surface and a convex posterior outer surfaces that are opposed to each other, the convex anterior outer surface and the convex posterior outer surface having opposite apexes defining a first width of the diaphragm from which the diaphragm tapers along the convex anterior outer surface and the convex posterior outer surface towards its distal end and its proximal end, wherein the main body comprises a left outer surface and a right outer surface opposed to each other extending between the convex anterior outer surface and the convex posterior outer surface and having a second width of the diaphragm perpendicular to the first width d, wherein the main body comprises a left suction chamber and a right suction chamber opposed to each other, which are separated from each other, and which are recessed in the main body, the left suction chamber being defined by a left inner surface which merges into the left outer surface along a left upper edge defining an opening to the left suction chamber, and wherein the right suction chamber is defined by a right inner surface which merges into the right outer surface along a right upper edge defining an opening to the right suction chamber.

A pessary according to claim 1, wherein the upper left edge and the upper right edge are elliptical upper edges whose short sides are opposite to each other in the insertion direction.

The pessary of claim 2, wherein the upper left elliptical edge and the upper right elliptical edge extend over at least half of their long sides at a constant distance from the adjacent convex front outer surface or convex rear outer surface.

A pessary according to any one of the preceding claims, wherein the left outer surface and the right outer surface are straight outer surfaces extending parallel to each other.

A pessary according to any one of the preceding claims, wherein the convex front outer surface, the left outer surface, the convex rear outer surface and the right outer surface are in a cross-section perpendicular to the insertion direction in a mutually rectangular arrangement.

A pessary according to any one of the preceding claims, wherein the distal support body comprises a distal upper support surface extending transversely to the insertion direction.

The pessary of claim 6, wherein the distal top support surface is a straight distal top support surface.

A diaphragm according to any one of the preceding claims, wherein the distal support body comprises a convex anterior support surface merging into the convex anterior outer surface, and a convex posterior abutment surface opposite the anterior support surface merging into the convex posterior outer surface, the anterior abutment surface and the posterior abutment surface between the transitions a third determine the width of the pessary.

A diaphragm according to any preceding claim, wherein the left inner surface and the right inner surface comprise a left bottom surface and a right bottom surface, respectively, which are straight and extend parallel and spaced apart in the main body.

A pessary according to any one of the preceding claims, wherein the left inner surface and the right inner surface comprise a left inner side surface and a right inner side surface, respectively, which are at an oblique angle to the respective adjacent left outer surface and right outer surface.

A diaphragm according to any preceding claim, wherein the oblique angle is constant along the periphery of the respective adjacent left top edge and right top edge.

A diaphragm as claimed in any preceding claim, wherein the main body comprises a rear suction chamber recessed within the main body, the rear suction chamber being defined by a rear inner surface which merges into the convex rear outer surface along a rear upper edge defining an opening to the rear suction chamber.

A diaphragm according to claim 12, wherein the rear top edge is an elliptical top edge whose short sides are opposite to each other in the insertion direction.

A pessary according to any one of the preceding claims, comprising a ureteral nodule protruding from the convex anterior outer surface.

The pessary of claim 14, wherein the ureteral nodule extends on the lower half of the main body located on the opposite side of the distal support body.

A pessary according to any one of the preceding claims, comprising a handling portion for manually handling the pessary, the handling portion comprising a finger grip that merges into the main body.

The pessary of claim 16, wherein the finger grip comprises an arc which merges into the main body, the arc defining a finger channel for insertion of a finger or thumb.

A pessary according to claim 17, wherein the finger channel extends perpendicular to the insertion direction.

A pessary according to claim 17 or 18, wherein the finger channel extends at least partially between the upper left edge and the upper right edge of the suction chambers.

A pessary according to any one of the preceding claims, wherein the main body and the support body jointly form a single unit.

A pessary according to any one of claims 16-20, wherein the main body, the support body and the handling portion together form a single unit.

A pessary according to any one of the preceding claims, which has a first plane of symmetry extending between the left suction chamber and the right suction chamber.

A pessary according to any preceding claim, having a second plane of symmetry for the distal support body, the left suction chamber and the right suction chamber extending between the convex front outer surface and the convex rear outer surface.

A diaphragm according to claims 22 and 23, wherein the first plane of symmetry and the second plane of symmetry are perpendicular to each other.

A pessary according to claim 24, wherein the insertion direction is parallel to the intersection of the first plane of symmetry and the second plane of symmetry.

A pessary according to any one of the preceding claims, wherein the convex front outer surface, the convex rear outer surface, the left suction chamber and the right suction chamber have a third plane of symmetry extending through the apices of the convex front outer surface and the convex rear outer surface.

A diaphragm according to claims 24 and 26, wherein the third plane of symmetry is perpendicular to the first plane of symmetry and the second plane of symmetry.

A pessary according to any one of the preceding claims, wherein the first width is between 30 millimeters and 60 millimeters.

A pessary according to any one of the preceding claims, wherein the first width is 45-60%, preferably 50-55% of the length of the pessary in the insertion direction.

A pessary according to any one of the preceding claims, wherein the second width is between 20 millimeters and 50 millimeters.

A pessary according to any one of the preceding claims, wherein the second width is 30-45%, preferably 35-40% of the length of the pessary in the insertion direction.

A diaphragm according to any one of the preceding claims, wherein the second width is 70-80%, preferably 72-76% of the first width.

A diaphragm according to any one of the preceding claims, wherein the first width is greater than the second width,

A diaphragm according to claim 8 or any one of the preceding claims when dependent on claim 8, wherein the third width is between 20 millimeters and 50 millimeters.

A pessary according to claim 8 or any one of the preceding claims when dependent on claim 8, wherein the third width is 20-45%, preferably 35-40% of the length of the pessary in the insertion direction.

A diaphragm according to claim 8 or any one of the preceding claims when dependent on claim 8, wherein the third width is 70-80%, preferably 72-76% of the first width.

A diaphragm according to any one of the preceding claims, wherein the diaphragm is made with or from a flexible, shape-retaining material.

The pessary of claim 37, wherein the pessary is made with either a silicone or a rubbery material.

A pessary according to any preceding claim for use in the treatment of prolapse of pelvic organs (POP) or for reducing the adverse effects thereof. -0-0-0-0-0-0-0-0-