Hegar dilators are

dilator Dilator or dilatator is a medical term with a number of uses, including: *A surgical instrument or medical implement used to induce dilation, that is, to expand an opening or passage such as the cervix (see cervical dilator), urethra, esophagus, ...

s used to treat

vaginismus Vaginismus is a condition in which involuntary muscle spasm interferes with vaginal intercourse or other penetration of the vagina. This often results in pain with attempts at sex. Often it begins when vaginal intercourse is first attempted. ...

and induce cervical dilation, and for inflatable penile implant procedures, though for penile implants it has been shown that outcomes are better ''without'' dilation.

Description

Hegar dilators were developed and introduced by Alfred Hegar in 1879 originally for use in the field of

gynecology Gynaecology or gynecology (see American and British English spelling differences) is the area of medicine concerned with conditions affecting the Female reproductive system, female reproductive system. It is often paired with the field of obste ...

. 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. 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. 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.

Use in the treatment of vaginismus

Hegar dilators are used to treat

, also known as genito-pelvic pain disorder. Patients with vaginismus use Hegar dilators of gradually increasing size, potentially followed by penetration by their partner. They have also found application in the management of

hymen The hymen is a thin piece of mucosal tissue that surrounds or partially covers the vaginal opening. A small percentage of females are born with hymens that are imperforate and completely obstruct the vaginal canal. It forms part of the vulva ...

al stenosis.

Cervical procedure use

Hegar dilators are used to induce

cervical dilation Cervical dilation (or cervical dilatation) is the opening of the cervix, the entrance to the uterus, during childbirth, miscarriage, induced abortion, or gynecological surgery. Cervical dilation may occur naturally, or may be induced surgically ...

in order to gain entry to the interior of the

uterus The uterus (from Latin ''uterus'', : uteri or uteruses) or womb () is the hollow organ, organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic development, embryonic and prenatal development, f ...

. During the process of dilation, the

cervix The cervix (: cervices) or cervix uteri is a dynamic fibromuscular sexual organ of the female reproductive system that connects the vagina with the uterine cavity. The human female cervix has been documented anatomically since at least the time ...

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. The dilators can also be used to sound the uterus.

Laminaria ''Laminaria'' is a genus of brown algae, brown seaweed in the order Kelp, Laminariales (kelp), comprising 31 species native to the north Atlantic and northern Pacific Oceans. This economically important genus is characterized by long, leathery L ...

rods have also been used to open up the cervix but work slowly as they increase size by absorbing water.

Non-gynecological uses

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

Hegar dilators (commonly, sizes 11 and 12) have been used during the insertion of two intracorporal cylinders into the

corpus cavernosum penis A corpus cavernosum penis (singular) (from Latin, characterised by "cavities/ hollows" of the penis, : corpora cavernosa) is one of a pair of sponge-like regions of erectile tissue, which contain most of the blood in the penis of several animal ...

during

penile implant A penile implant is an Implant (Medicine), 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, inclu ...

procedures, but it has been shown that outcomes are better ''without'' this dilation, which destroys erectile tissue. 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.{{cite journal, last1=Al-Shaiji, first1=TariqF, last2=Al-Enezi, first2=Ahmad, last3=Al-Khadhari, first3=Sulaiman, title=Three-piece inflatable penile prosthesis: Surgical techniques and pitfalls, journal=Journal of Surgical Technique and Case Report, date=2011, volume=3, issue=2, pages=76–83, doi=10.4103/2006-8808.92798, pmid=22413049, pmc=3296438 , doi-access=free

References

Surgical instruments Gynaecology