DESCRIPTION The present invention relates to a pessary, a device for the treatment of pelvic organ prolapse (POP) in women, characterized in that it integrates a passive system aimed at providing mechanical support to the walls of the vagina with a douching system of the vagina itself by capillary douche irrigation along its walls, which can be connected to an external irrigation unit, also when the pessary is in situ, to prevent complications deriving from the prolonged presence and the repeated insertion and extraction maneuvers of the current vaginal pessaries, such as irritation, erosion, bleeding and malodorous discharge.

Field of the invention

Pelvic organs, such as the uterus, the bladder, and the bowels, may protrude into the vagina because of weakness in the tissues which normally support them. The symptoms they cause depend on the type of prolapse. Pessaries (mechanical devices usually made of latex or silicone) may be used to attempt to restore the prolapsed organs to their normal position and thus relieve the symptoms. They are commonly used, whenever conservative treatments, such as physical therapy and surgery, have either failed or are not appropriate.

Recent studies in the sector have highlighted the fact that pelvic organ prolapse is common and is found in over 50% of multiparous women in a clinical setting (Swift 2000). In the population as a whole, it is estimated that 30% of women have signs of prolapse although the majority are asymptomatic (Samuelson 1999). These data immediately indicate how important the pathology is.

Background art.

Various vaginal devices for POP treatment have been in use for many years. These are normally made of solid material and, to ensure proper operation, must be as wide as possible to serve as a mechanical barrier, preventing the extrusion of the pelvic organs through the introitus. This makes it difficult and painful to insert the device and then remove it for cleaning. However, this is necessary because the prolonged use of the device causes vaginal dryness and if the device is not cleaned regularly it can lead to even serious infections.

Several inflatable devices have been suggested to overcome these problems. Cf., for example, inter alia, U.S. Patent n. 2,638,093, 3,646,929, 4,019,490 and 4,920,986, and again U.K. patent n. 1,115,727.

However, all of these devices, as well as other inflation devices on the market, have two main disadvantages: air can leak from inside the inflatable body with use, which is detrimental to the containment effectiveness of the device; and even if the insertion and extraction operations are somehow facilitated, the problem of allowing an effective douching in situ has never been faced, making it necessary to extract the pessary for hygienic reasons, clean it thoroughly and reinsert it, reusing the device multiple times.

WO 2012/049676 A2, GB 05103 A AD 1909, and WO 2018/213187 all describe a pessary for the correction of bladder and/or uterine prolapse support wherein the pessary comprises a multilevel body comprising a deck ergonomically shaped to adapt to the vaginal morphology, which performs the function of antiprolapse support, a tubular element closed at its ends, which follows and is fixed to the profile of said deck and is provided with holes for the distribution of a douche on the walls of the vagina, and a tube protruding from said tubular element for introducing said douche into said tubular element from the outside, leaving said pessary in situ.

However, none of the documents of the available background art describe a pessary which is easy to insert and which can be connected to either an inflating tube or an irrigation unit.

From the above, it is apparent that there is a need for a vaginal device which offers soft and adjustable support, eliminates any difficulty during the insertion and extraction operations from the vagina, and is provided with means for spraying, once in situ, refreshing, hygienic and medical substances, to allow such an operation without needing to remove the device from the vagina each time, thus reducing the possibility of infection. Substantially, in a first embodiment, the vaginal pessary of the present invention is made of substantially elastic material compatible with its use, consisting of a multilevel body comprising: a deck ergonomically shaped to adapt to the vaginal morphology, which provides the function of anti-prolapse support; a tubular element, closed at its ends, which follows and is attached to the profile of said deck, and is provided with an array of holes appropriately distanced for the distribution of a vaginal douche, and a tube for introducing the douching liquid into such a tubular element from the outside.

For the tubular element to be integral with the deck, the latter is provided with coupling means regularly distributed along its profile.

In a second embodiment, to facilitate the introduction of the described pessary into the vagina, it is provided that the deck itself is deformable, being made up of rigid parts and inflatable parts which can be a series of parallel transversal elements or one or more axial elements, perpendicular to the preceding ones, all connected to a small inflating tube which runs along one of the side branches of the toroidal douching element and then protrudes in the same manner as the douche feeding tube.

In a third embodiment, the deck is shown by a flat inflatable air chamber surrounded by a toroidal element for the distribution of the douche, which follows the profile of said deck, there being provided a protruding tubular fitting for the inflating air of the deck and a second fitting for the introduction of the douching liquid into the toroidal distribution element.

Further features and advantages of the invention will be apparent from the following detailed description with reference to the accompanying drawings which illustrate a preferred embodiment by way of a non-limiting example of the invention.

In the figures: figs. 1A and 1B are a perspective view from the top and the bottom of an endovaginal device according to a first embodiment; figs. 2A and 2B are perspective views from the top and the bottom of an endovaginal device related to the second embodiment; fig. 3 is a plan view from the top of the upper face of a vaginal device wherein the deck consists of a single flat air chamber the distal end of which displays a succession of three protruding profiles of shockproof material to prevent possible damage to the wall of the vagina, while two tube stretches protrude from its proximal end, one for the introduction of the inflating air and the other for the egress of the douching liquid; fig. 4 is a profile view of the vaginal device in fig. 3; fig. 5 is a section view taken along section plane A-A in fig.4; fig. 6 is a section view taken along section plane C-C in fig. 3; fig. 7 is a section view taken along section plane B-B in fig. 3.

With reference to the figures, the pessary object of the invention consists of a rigid flat-shaped component or deck 2, ergonomically shaped to adapt to the vaginal morphology, which is contoured on its curved distal front end and its two mutually straight sides 4 and 6 by an extruded tube 8 of a material compatible for use, provided with a plurality of holes 10, for the distribution of vaginal douche.

In the embodiment shown in figs. 1A,1B, the mounting of the sprayer tube 8 on the deck 2 is achieved by virtue of the elasticity of the tube itself, which is bent to pass through sleeves 12 which protrude outside the perimeter of the deck 2, to assume its configuration. The two proximal ends of the tube are closed by caps 16, one of which is provided with a connection to a protruding feeding tube 18 which allows a vaginal douche to be introduced even when the pessary is in situ.

According to a first variant of the invention shown in figs. 2A and 2B, the deck 2 is partially made of inflatable material, comprising at least one inflatable element 20 arranged axially (as in the figure), but also transversely, and even better a series of parallel transversal elements, all connected to an inflating tube 22, obviously of small diameter, which runs along the straight side opposite to the one where the douche feeding tube 18 opens. In this manner, when the inflatable element or elements either is or are deflated, it is easy to introduce the pessary into the vagina and inflate it before positioning the balloon which is responsible for correcting bladder and/or uterine prolapse. In the illustrated case, the element 20 provides the required support 24 for the anti-prolapse balloon.

Figure 3 shows another embodiment in which the deck comprises a single flat air chamber 30, the distal end of which comprises a succession of two full bodies 26 which embrace the tubular contour 28 of the deck, wherein a plurality of distribution channels 32 are present of the douche fed through an inlet tube 34 which runs parallel to the introduction side of the inflating air tube 36.

Such a design facilitates the insertion of the pessary into the vagina, which, once in situ, can be connected to both the inflating air tube and the douching fluid irrigation device.

Some preferred embodiments of the invention were described hereto. It is finally apparent that many variations can be made by a person skilled in the art without because of this departing from the scope of protection as defined by the appended claims.