Postirradiation Vaginal Occlusion: Nonoperative Management

Abstract

The effects of irradiation therapy on the surrounding pelvic structures are well known. Most women develop some degree of vaginal stenosis following irradiation for cervical cancer. Although complete vaginal occlusion is less common, it seriously affects the patient's self-image. The author treated five patients who had complete vaginal occlusion following irradiation for stage II uterine cervical carcinoma. By means of a regimen of digital pressure and an estrogenic cream, for an average of six weeks, the function of the vagina was restored.

Vaginal dilator therapy for women receiving pelvic radiotherapy

“…There are five observational studies that comment on vaginal length but they have been excluded from the formal analysis for one of the following reasons: no relevant data was available (Bruner 1993);historical controls were used to compare with the intervention group (Decruze 1999);was a case series of only five women (Poma 1980);there is no control group and therefore we do not know what would have happened if dilation had not been suggested (Velaskar 2007);the focus was on the application of mitomycin with a speculum (Sobotkowski 2006). …”

“…The report by Poma 1980 consists of five case reports. The authors suggest that dilation can work when used for a median of eight years after radiotherapy.…”

Radiation-induced vaginal stenosis: current perspectives

“…There have been a small number of studies assessing such topical therapies 42–45. One study43 showed outcome improvement with the use of vaginal estrogen applications in acute and late toxicity.…”

Management of Incarcerated Vaginal Pessaries

“…The delay in diagnostic curettage involved by the approach described here, is minimal. Moreover, the improved condition of the vagina facilitates not only the removal procedure but future evaluation (6).…”