Osmotic dilator for cervical preparation in Gynaecology

Go to Dilapan-S in IOL: Obstetrics
Dilapan-S Summary
Clinical Benefits in TOP
Clinical Benefits in IVF
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Safe, gentle and predictable

Effective cervical priming

4-6 hours mechanism

Cost effective: 1-day procedures

✔  Gentle, high efficacy1,2 and predictable

✔ Recommended in NICE NG140 guidelines

✔ Wide range of applications e.g. prior to TOP, ET, Hysteroscopy

✔ Shorterns hospital stays4

✔ Allows same day D&E prodcedures1,2

✔ Easy to insert and remove

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What is Dilapan-S®?

Dilapan-S® is an osmotic cervical dilator with applications in both gynaecology and obstetrics. It is made of synthetic hygroscopic gel which absorbs fluid from the cervical canal tissue to temporarily dehydrate and dilate the cervix without causing tissue damage.  

How does Dilapan-S® work?

  • Mechanical: as the rods expand, the apply gentle pressure to the cervical wall over a 4-6 hour period. This allows atraumatic, predictable and and efficient dilation.
  • Biophysical: By the process of osmosis, Dilapan-S rods temporarily dehydrate the cervical tissue
  • Physiological: During expansion, it promotes softening of the cervix, causing collagen degradation and tissue restructuring.
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    • In gynaecology, osmotic cervical dilation is recommended for surgical termination of pregnancy (between 14+0 and 23+6 weeks) in the NICE Guidelines (NG140).
    • Cervical preparation with Dilapan-S® also enables easier embryo transfer during assisted reproduction and facilitates other procedures (e.g, hysteroscopy) which require access to the intrauterine cavity for insertion and removal of devices.
    • Dilapan-S® is available in a range of sizes for different procedures. 
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    Clinical Benefits in TOP

    Dilapan–S® represents one of the most preferred methods for cervical preparation prior D&E procedure in second trimester thanks to its predictability, efficacy and safety.

    • In comparison with misoprostol, Dilapan-S® offers higher efficacy and better predictability to help avoid challenging situations1,2.  
    • Dilapan-S® can be used for same-day D&E procedures for both late 1st and 2nd trimester, reduced hospital stay which could produce cost savings1,2.  
    • Evaluated by the SFP Guidelines as the best product in its class1.  
    • Dilapan-S® can be used in combination with Misoprostol, and can therefore decrease the dose of misoprostol3.
    • No adverse outcomes have been reported with Dilapan-S®, including infections.   
    • Half the time from Induction to Delivery in second trimester TOP with Dilapan-S® compared to misoprostol (5h48m vs 10h18m)3. 
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    Dilapan-S avoids unwanted pharmaceutical side effects such as nausea, vomiting and cramping.

    The mode of action is atraumatic, significantly reducing the risk of cervical injury and importantly maintains the full functionality of the cervix for future pregnancies.

    Minimise the risk of uncontrolled abortions e.g. during the night.

    Enabling one day procedures reduces the length of stay and therefore produces cost savings.

    Over 90% of clinicians found Dilapan-S easy to insert and remove.

    Dilapan-S is latex free and contains no animal product.

    4mm x 65mm is the appropriate length for TOP, slightly longer than the length used for IOL due to the longer cervix at the earlier gestations.

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    Dilapan-S® for difficult embryo tranfers in IVF:

    Dilapan-S® can be used to increase success of embryo transfers (ET) in IVF4.  

    Usually, Dilapan-S® is used when one of the following occurred in the previous embryo transfer:  

    • One previous unsuccessful ET cycle  
    • The catheter had resistance 
    • Need to change the catheter during ET  
    • Blood was found on the catheter in ET  
    • Needed to grasp the cervix with a tenaculum  
    • Pain was reported during previous ET  

    Such patients should be offered Dilapan-S® before the second attempt of ET.  

    Dilapan-S® rods are inserted into the cervix for 4 hours. Once removed, gonadotrophin stimulation can begin if needed.  

    1 rod is sufficient. 3mmx55mm is the suitable size for ET.  

    In a clinical study conducted by UCLH4: 

    “The Dilapan-S rods were placed intracervically and left for 4 h prior to starting gonadotrophin stimulation as an outpatient procedure.    RESULTS: Of the 54 patients who originally had difficult embryo transfer, 43 patients (79.5%) had subsequent easy embryo transfer. Thirty patients managed to conceive, giving a clinical pregnancy rate of 55%.    CONCLUSIONS: Cervical dilatation using hygroscopic dilators facilitates difficult embryo transfer and helps to improve the pregnancy rate.” 
    View paper here 

    Product Information 

    • 4mmx65mm for cervical priming in TOP – Sold in boxes of 25. Product code DS000-4X65
    • 3mmx65mm for difficult embryo transfers – Sold in boxes of 25. Product code –DS000-3X55
    • Dilapan-S is stored at room temperature and has minimum shelve life of 2 years.
    • Each rod is individually packaged and sterilised.