All the warnings in this thread are spot on, correct and must be heeded! I have had my cervix dilated many times under the hand of my OB/GYN for endometrial biopsies over the many years. The whole process is torture! Nevermind the injecting drugs available to pierce my cervix. For me, they hardly work enough to allow the needle piercing/stabbing me internally. My BP has crashed dangerously low, and spiked dangerously high during the dilation and the whole experience in itself. My GYN is very seasoned and has done them for many years and he is fully aware of what my body potentially will do during this as well as after. He makes sure he has emergency equipment on hand in case it is needed.
Play docs, play patients, DO NOT PLAY AROUND WITH THIS! IT IS DANGEROUS! I have seen posts where it is claimed by play docs and play patients they have never had a bad experience. Ignore those DANGEROUS posts, DO NOT BELIEVE THEM! DO NOT ENGAGE IN THIS TYPE OF PLAY! To those play docs and play patients who are stupidly, selfishly, irresponsible for doing this, it is ONLY A MATTER OF TIME UNTIL SOMETHING GOES WRONG AND YOU WON'T BE ABLE TO HANDLE IT, FIX IT FAST ENOUGH, CALL FOR EMERGENCY RESPONSE FAST ENOUGH TO RESPOND TO YOU! What would happen if YOU perforated HER uterus? YOU would NOT be able to control bleeding if you lacerated the cervix or a large blood vessel? What about infection risks??? THIS IS NOT a procedure for a home gamer!!!
The following post by saragyn plainly explains why this is clearly VERY DANGEROUS to do by anyone other than someone who is properly trained with emergency equipment available to use if needed!
while I agree this is a procedure not suited for play I think a calm detailed explanation is best especially since a good bit of research will point towards a far less risky outcome than is stated in this chain. Many studies relate infection risk around 5% and blunt instrument perforation of the uterus much the same so if you go read up on the facts you may think the risk is being over stated here in this chain
Obviously the study data you are going to find is based on the outcomes of procedures performed by professional gynecologists. The problem is that along the way there are multiple opportunities to cause harm since you, as a play doctor, obviously have neither the training or tangible experience of an actual practicing gynecologist to avoid causing said harm. The biggest issue is going to be perforation of the uterus by the dilator. In order to avoid that possibilty you have to have your act together - my bet is that you don't, and it's a crap shoot as to whether or not you will cause serious damage
First the pelvic exam is required- you need to assess uterus size, version and flexion, basically the relational angles of the cervix and uterus. You also need to assess the adnexa, cul de sac and ligaments. My guess is that you as a play doctor know what a bimanual and rectovaginal exam is, but not what you are specifically assessing during this process. This is big risk number one. Now you need to decide on the type of tenaculum to use - one, two tooth - my guess is you either do not have a tenaculum, and or you are not certain which to use or how to use it. Big mistake number two as choosing the wrong instrument may cause cervical lacerations. The tenaculum is critical in providing angle and traction. Big mistake number three - traction and angle determine force required to insert the dilator and as a play doctor you probably have little experience in this. How about holding the dilator and how far do you insert it - again as a play doctor you may insert too deep, especially considering all of the previous steps which you are unsure of - you may insert into the fundus damaging the endometrium and or cause perforation. So what if bleeding occurs - did you lacerate the cervix, is the bleeding from the endometrial lining, did you casue a blunt instrument perforation, how do you know which, do you rush to the emergency room, carefully watch the situation - as a play doctor where is your experience in this ?
So while I don't at all mean to undermine other commments, and don't take this the wrong way, infection is the least of your concerns here - this is all about skill and the tactile data you must aquire in order to perform a specific procedure which is nothing like inserting a speculum and simply playing doctor. Once you know what you are doing dilating the cervix is quite safe and rarely results in serious complications -- in the hands of a practicing physician.
Hopefully this helps explain in enough detail the reasons why you just need to leave this one alone. Lots of other fun things to do
sarah
Steve75752 has written:
"Really don't try this at home kids. Performing this clinical procedure is not just a matter of having read an article or some textbook knowledge. Nurse Practitioners and physicians spend years acquiring not only knowlege but also years of clinical experience and the essential skills. Before this procedure is even attempted for the first time it is after years of formal preparation and with the observation and supervision of a skilled practitioner. Even in the best situation under ideal conditions there could be complications with serious consequences. I assure you however frequent and common a procedure it may be, it is only performed when the considered benefits for the patient outweigh the significant risks, many precautions are taken to reduce those risks and having the medical capability to manage any subsequent adverse events that might occur."
Switchablesusie has written:
"This has been well discussed in other threads. DO A SEARCH.
The reason not to do cervical dilation, in a nutshell is three fold.
1--The uterus is sterile and very susceptible to infection
2--Possible sterility--inability to have children.
3--Possible perforation, uncontrolled bleeding, DEATH."
AMEN!!!
Andie