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. ...

, induce

cervical In anatomy, cervical is an adjective that has two meanings: # of or pertaining to any neck. # of or pertaining to the female cervix: i.e., the ''neck'' of the uterus. *Commonly used medical phrases involving the neck are **cervical collar **cerv ...

dilation, and for inflatable penile implant procedures.

Description

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

Gynecology Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined are ...

. 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 8mm 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 3mm - 17mm for single-ended dilators or 3mm/4mm - 17mm/18mm for double-ended dilators, though configurations with sizes anywhere from 1mm to 26mm 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 external vaginal opening. It forms part of the vulva, or external genitalia, and is similar in structure to the vagina. In children, a common appearance of the h ...

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 o ...

in order to gain entry to the interior of the

uterus The uterus (from Latin ''uterus'', plural ''uteri'') 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 uter ...

. During the process of dilation, the

cervix The cervix or cervix uteri (Latin, 'neck of the uterus') is the lower part of the uterus (womb) in the human female reproductive system. The cervix is usually 2 to 3 cm long (~1 inch) and roughly cylindrical in shape, which changes during ...

may have to be stabilized with a

tenaculum A tenaculum is a surgical instrument, usually classified as a type of forceps. It consists of a slender sharp-pointed hook attached to a handle and is used mainly in surgery for seizing and holding parts, such as blood vessels.Merriam-Webster Onl ...

, 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. Hegar dilators are widely used in gynecology to open up the cervix. This may be necessary prior to a uterine

curettage Curettage ( or ), in medical procedures, is the use of a curette (French, meaning scoopMosby's Medical, Nursing & Allied Health Dictionary, Fourth Edition, Mosby-Year Book 1994, p. 422) to remove tissue by scraping or scooping. Curettages are ...

or biopsy. They are also used to overcome

stenosis A stenosis (from Ancient Greek στενός, "narrow") is an abnormal narrowing in a blood vessel or other tubular organ or structure such as foramina and canals. It is also sometimes called a stricture (as in urethral stricture). ''Stricture'' ...

in non-gynecological situations, such as in

urology Urology (from Greek οὖρον ''ouron'' "urine" and '' -logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive org ...

and

proctology Colorectal surgery is a field in medicine dealing with disorders of the rectum, anus, and colon. The field is also known as proctology, but this term is now used infrequently within medicine and is most often employed to identify practices rela ...

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

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

Penile implant procedure use

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

Corpus cavernosum penis A corpus cavernosum penis (singular) (literally "cave-like body" of the penis, plural corpora cavernosa) is one of a pair of sponge-like regions of erectile tissue, which contain most of the blood in the penis during an erection. Such a corpus ...

as part of an Inflatable penile implant procedure. 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

References

Surgical instruments Gynaecology