Vaginal stenosis after radiation therapy for pelvic cancer: prevention and treatment options - a review of the current literature

Purpose: Pelvic radiotherapy holds a vital role in the management of gynaecological and pelvic gastrointestinal cancers. However, radiotherapy can result in shortening and narrowing of the vagina which is known as vaginal stenosis. The objective of this paper is to review the prevention and treatment options of radiation-induced vaginal stenosis and discuss their benefits and side-effects as well. Materials and Methods: A literature search was performed (1972-2017) on PubMed, Cochrane Database of Controlled Trials, and SCO-PUS with no language restrictions. Cross references from the included studies were hand-searched. The criteria for the included studies were any and every measure for preventing radiation-induced vaginal stenosis. Results: The use of vaginal dilators, sexual intercourse, and topical therapies are the current options for the management of vaginal stenosis after pelvic radiotherapy. Conclusion: Vaginal dilation should be encouraged in cancer survivors after pelvic radiotherapy, with counseling by expertized medical and paramedical personnel. Limited evidence exists in favor of the use of vaginal lubricating creams for radiation-related vaginal irritation.

Anal-rectal cancer; Brachytherapy; Gynecological cancer; Pelvic radiotherapy; Vaginal dilation; Vaginal stenosis

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