Vaginal Dilators: Issues and Answers

2020 ◽  
Author(s):  
Marisa Liu ◽  
Mark Juravic ◽  
Genevieve Mazza ◽  
Michael L. Krychman
Keyword(s):  
Vaginal Dilators

Vaginal Dilators for Prevention of Dyspareunia After Prolapse Surgery

2013 ◽  
Vol 121 (6) ◽  
pp. 1273-1280 ◽  
Author(s):  
Danielle D. Antosh ◽  
Robert E. Gutman ◽  
Amy J. Park ◽  
Andrew I. Sokol ◽  
Joanna L. Peterson ◽  
...  
Keyword(s):  
Prolapse Surgery ◽  
Vaginal Dilators

VAGINAL DILATORS

1949 ◽  
Vol 56 (3) ◽  
pp. 446-446
Author(s):  
W. McKim H. McCullagh
Keyword(s):  
Vaginal Dilators

Feasibility of a sexual health program for women receiving pelvic radiation therapy for gynecologic and lower GI cancers.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 135-135
Author(s):  
Lorraine C. Drapek
Keyword(s):  
Sexual Health ◽  
Sexual Function ◽  
Health Survey ◽  
Current Evidence ◽  
Health Clinic ◽  
Long Term Effects ◽  
Pelvic Radiation ◽  
Vaginal Stenosis ◽  
Vaginal Dilators

135 Background: Long term effects of pelvic radiation for women include vaginal stenosis, leading to distress regarding sexual function. The NCCN guidelines recommend asking patients about sexual function at frequent intervals. NCCN recommends the use of vaginal dilators for women who have had pelvic radiation. Vaginal dilators have been widely recommended to minimize these long term effects. However, current evidence demonstrates poor adherence (less than 50%) of vaginal dilator use. Methods: A sexual health clinic was implemented at the radiation oncology department of a large academic medical center. This initiative consisted of three visits with a nurse practitioner over a twelve week period. The first visit was completed prior to the start of radiation, consisted of sexual history, completion of the PROMIS sexual health survey, and education regarding vaginal stenosis. The importance of the use of vaginal dilators following the completion of radiation was emphasized.. The second visit occurred at the completion of radiation and consisted of the PROMIS sexual health survey, and reinforcement of the use of vaginal dilators. Patients were instructed to begin use of vaginal dilators two weeks later. Each patient was given a set of four vaginal dilators, and a vaginal dilator diary. The third visit was completed six to eight weeks post treatment and consisted of completion of the PROMIS sexual health survey, review of the vaginal dilator diary, discussion of patient progress, and reinforcement of education. Results: From August 2016 to September 2017, 38 patients were approached and all completed the first visit (100%). Twenty-three patients completed the second visit (61%). Thirteen patients have completed all three visits (35%). At the end of three visits 11 (85%) of 13 patients were using vaginal dilators, and three had become sexually active. Conclusions: This program demonstrates a high enrollment and completion rate, as well as an important survivorship issue for women undergoing pelvic radiation. The reinforcement of long term effects of radiation enabled patients to understand the importance of using vaginal dilators in to maintain vaginal health and maintain sexual function.

Perceived versus measured functional vaginal capacity in cancer patients with sexual function concerns.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 170-170
Author(s):  
Vanessa Amy Kennedy ◽  
Stacy Tessler Lindau ◽  
Seiko Diane Yamada ◽  
Kristen Wroblewski ◽  
Emily Abramsohn ◽  
...  
Keyword(s):  
Sexual Function ◽  
Cancer Survivors ◽  
Sexual Activity ◽  
Gynecologic Cancer ◽  
Male Partner ◽  
Cross Sectional ◽  
Patient Reported ◽  
Sexual Concerns ◽  
Vaginal Dilators ◽  
Loss Of Libido

170 Background: Actual and perceived loss of vaginal capacity can be a source of distress among female cancer survivors. The objective of this study was to assess perceived (PC) versus measured (MC) functional vaginal capacity in patients presenting with sexual function concerns. Methods: This was a cross-sectional registry-based study of women seen at the Program in Integrative Sexual Medicine for Women and Girls with Cancer (PRISM) Clinic. During the visit, patients were presented with graduated vaginal dilators and asked to select the largest dilator they perceived could be inserted without pain (PC) and the dilator representing their desired functional capacity (DC) (for patients with a male partner, this was the size closest to the partner’s erect penis). Two models of dilators were offered. Dilators were numbered 1-24 in order of increasing volume. If the patient could accommodate the dilator chosen as PC without pain, she was examined with dilators of gradually increasing size until the patient reported discomfort. The largest dilator tolerated without pain was MC. Differences between PC and MC, and between DC and MC were calculated. The association between penetrative sexual activity in the prior 4 weeks and accuracy of PC was assessed using the Mann-Whitney U test. Results: Mean patient age was 46 years (range 21-80, N=69). Most patients had breast (43%) or a gynecologic cancer (16%); 29% had benign disease. Nearly half reported two or more sexual concerns; painful intercourse (81%), vaginal complaints (21%), and loss of libido (19%) were most common. Median PC was 50cm3 (IQR 35-65cm3), median MC was 81cm3 (IQR 60-90cm3), and median DC was 90cm3 (IQR 81-132cm3). PC equaled MC in 22%. PC was less than MC in 75% and less than DC in 81% of patients. Of patients with PC less than DC, 41% had MC equal to or larger than DC. PC was closer to MC in patients reporting penetrative sexual activity in the prior 4 weeks (p=0.02). Conclusions: In this single-site study, many cancer survivors seeking care for sexual concerns underestimate their functional vaginal capacity. Further study is needed to determine whether correcting patient perception of capacity lessens distress and improves function.

Vaginal Dilators

2005 ◽  
Vol 29 (2) ◽  
pp. 30
Author(s):  
Patti Green
Keyword(s):  
Vaginal Dilators

scholarly journals Topical estrogen, testosterone, and vaginal dilator in the prevention of vaginal stenosis after radiotherapy in women with cervical cancer: a randomized clinical trial

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jumara Martins ◽  
Ana Francisca Vaz ◽  
Regina Celia Grion ◽  
Lúcia Costa-Paiva ◽  
Luiz Francisco Baccaro
Keyword(s):  
Clinical Trial ◽  
Cervical Cancer ◽  
Randomized Clinical Trial ◽  
Open Label ◽  
Treatment Groups ◽  
Vaginal Stenosis ◽  
Significant Difference ◽  
Vaginal Dilators ◽  
The Mean ◽  
Topical Estrogen

Abstract Background We aimed to evaluate the effects of different therapeutic options to prevent the evolution of vaginal stenosis after pelvic radiotherapy in women with cervical cancer. Methods open-label randomized clinical trial of 195 women, stage I-IIIB, aged 18–75 years, using topical estrogen (66), topical testosterone (34), water-based intimate lubricant gel (66), and vaginal dilators (29) to assess the incidence and severity of vaginal stenosis after radiotherapy at UNICAMP-Brazil, from January/2013 to May/2018. The main outcome measure was vaginal stenosis assessed using the Common Terminology Criteria for Adverse Events (CTCAE) scale and percental changes in vaginal volume. The women were evaluated at four different times: shortly after the end of radiotherapy, and four, eight, and 12 months after the beginning of the intervention. Statistical analysis was carried out using Symmetry test, Kruskal-Wallis test and multiple regression. Results the mean age of women was 46.78 (±13.01) years, 61,03% were premenopausal and 73,84% had stage IIB-IIIB tumors. The mean reduction in vaginal volume in the total group was 25.47%, with similar worsening in the four treatment groups with no statistical difference throughout the intervention period. There was worsening of vaginal stenosis evaluated by CTCAE scale after 1 year in all groups (p < 0.01), except for the users of vaginal dilator (p = 0.37). Conclusions there was a reduction in vaginal volume in all treatment groups analyzed, with no significant difference between them. However, women who used vaginal dilators had a lower frequency and severity of vaginal stenosis assessed by the CTCAE scale after one year of treatment. Trial registration Brazilian Registry of Clinical Trials, RBR-23w5fv. Registered 10 January 2017 - Retrospectively registered.

Vaginal atresia treated successfully with vaginal dilators

2002 ◽  
Vol 22 (3) ◽  
pp. 326-326
Author(s):  
A. L. Blackwell ◽  
M. D. Gillmer
Keyword(s):  
Vaginal Atresia ◽  
Vaginal Dilators

Vaginal Dilator Use to Promote Sexual Wellbeing After Radiotherapy in Gynaecological Cancer Survivors: A Prospective Observational Study

2021 ◽  
Author(s):  
Dimitra Charatsi ◽  
Polyxeni Vanakara ◽  
Michail Nikolaou ◽  
Aikaterini Evaggelopoulou ◽  
Dimitrios Korfias ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Survivors ◽  
External Beam Radiotherapy ◽  
Sexual Life ◽  
P Value ◽  
Sexual Rehabilitation ◽  
Vaginal Stenosis ◽  
Sexual Symptoms ◽  
Radiation Induced ◽  
Vaginal Dilators

Background: Since continuing advances in radiotherapy technology broaden the role of radiotherapy in the treatment of gynaecologic malignancies, the use of vaginal dilators has been introduced in order to mitigate the risk of vaginal stenosis. The main aims of this study were to investigate the vaginal dilator use efficacy in the treatment of radiation-induced vaginal stenosis and the vaginal dilator effect on sexual quality of life. Methods: We studied fifty-three patients with endometrial or cervical cancer. The participants were treated with radical or adjuvant external beam radiotherapy and/or brachytherapy. They were routinely examined at four time points post-radiotherapy when also they were asked to fill in a validated sexual function-vaginal changes questionnaire. A p-value less than 0.05 was considered statistically significant. Results: The vaginal stenosis grading score was decreased and the size of the vaginal dilator comfortably insertable was gradually increased throughout the year of vaginal dilator use while radiation-induced vaginal and sexual symptoms were improved throughout the year of VD use. All patients with initial grade 3 showed vaginal stenosis of grade 2 after 12 months of vaginal dilator use and 65.8% of the patients with grade 2 initial vaginal stenosis demonstrated final vaginal stenosis grade 1 while 77.8% of the participants with initial 1st size of vaginal dilators reached the 3rd vaginal dilator size after 12 months. Starting time of dilator therapy <= 3 months after the end of radiotherapy was associated with a significant decrease in vaginal stenosis. Additionally, there was an overall upward trend regarding patients’ satisfaction with their sexual life. Conclusion: Endometrial and cervical cancer survivors should be encouraged to use vaginal dilators for the treatment of vaginal stenosis and sexual rehabilitation after radiotherapy.

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