Use Of Vaginal Dilators Research Articles

Treatment of vaginal agglutination associated with chronic graft-versus-host disease

Objective: To describe the presentation and clinical course of two patients after development of vaginal agglutination associated with chronic graft-versus-host disease. Design: Case report. Setting: Tertiary referral center for pelvic reconstructive surgery. Patient(s): Two patients with the diagnosis of chronic graft-versus-host disease who later developed vaginal agglutination requiring treatment. Intervention(s): Surgical lysis of vaginal adhesions and postoperative use of vaginal dilators. Main Outcome Measure(s): Successful treatment of vaginal adhesions. Result(s): Both patients underwent successful surgical lysis of vaginal adhesions and maintained vaginal patency with postoperative use of vaginal dilators. Conclusion(s): Prompt diagnosis of vaginal agglutination in patients with chronic graft-versus-host disease and appropriate surgical correction of this complication rather than prophylaxis is the correct treatment course.

Laparoscopic hysterectomy and assisted Vecchietti procedure to treat congenital cervical and vaginal atresia

ObjectiveTo report a case of complete cervical and vaginal atresia treated by laparoscopic hysterectomy and assisted Vecchietti procedure.SubjectAn 18‐year‐old woman requesting formation of a neovagina. The initial diagnosis of cervical and vaginal atresia had been made by ultrasound and confirmed by laparoscopy when the patient was aged 15 years.ResultsNo intra‐ or postoperative complications were recorded. A neovagina with a depth of 7 cm and width of 1.5 cm was created. Subsequent use of vaginal dilators produced a functional vagina at 6 weeks postoperatively.ConclusionThe use of laparoscopy to treat Müllerian anomalies, with the benefits of reduced postoperative morbidity and excellent cosmesis, should be supported.

Changes in sexual behavior following radiation therapy for cervical cancer.

Twenty-one women with cervical cancer Types I and II, treated by radiation were evaluated by comparing periods before cancer and after therapy in order to identify changes in sexual behavior; if so, whether they attributed the changes to therapy, or whether other factors were associated with being sexually dysfunctional or non-dysfunctional. Data were obtained through administration of a sexual behavior questionnaire, personal interviews and review of medical records. Statistically significant changes were found: decreased frequency of masturbation and intercourse, decreased frequency of orgasm through non-coital sexual activities, less satisfaction with sex, and less enjoyment of intercourse. The majority believed that changes were due to radiation therapy and reflected decreased feelings of self-esteem, sex desirability and attractiveness. Most of the women believed that cancer could be transmitted through intercourse. Women who did not follow advice regarding use of vaginal dilators and did not resume their pre-illness level of sex were more likely to develop physical and sexual changes. The subjects' need for sexual counselling concerning the effect of the illness and treatment on relationships with partners was strongly evident. Suggestions for preventing undesirable physical and psychological changes, and guidelines for counselling are provided.

Collaboration between a psychologist and a woman physician in the treatment of non-consummation of marriage: Two case studies

Abstract Two cases of unconsummated marriage are presented. In each case the problem was of many years standing (8–10 years). Treatment was successful in both instances after several months of marital/sexual psychotherapy. At a critical point in each treatment the psychotherapist, a female clinical psychologist, obtained the assistance of a woman physician who performed an internal examination and instructed the woman in the use of vaginal dilators. An eclectic approach combining behavioural and psychodynamic treatment methods helped to achieve a satisfactory conclusion for each couple. The case material is discussed in the context of Friedman's (1962) taxonomy of the psychodynamics of unconsummated marriages: The Sleeping Beauty, Gentling Brunhilde and The Queen Bee.

The gynecological implant patient

Purpose: Although vaginal dilation is often recommended to minimize or prevent vaginal scarring after pelvic radiotherapy, compliance with this recommendation has historically been very low. Therefore, effective intervention strategies are needed to enhance compliance with vaginal dilation after radiotherapy for gynecologic cancer.Methods and Materials: This study was a randomized controlled clinical trial of a psychoeducational intervention specifically designed to increase compliance with vaginal dilation. The information-motivation-behavioral skills model of enhancing compliance with behavioral change was the basis for the intervention design. Forty-two sexually active women, 21 to 65 years of age, diagnosed with Stages Ic–III cervical or endometrial cancer, who received pelvic radiotherapy, were randomized to either the experimental psychoeducational group or the information-only control group. Assessment via questionnaire occurred before treatment and at 6-week, 6-month, 12-month, 18-month, and 24-month follow-up. Assessment via interview also occurred at 6-month, 12-month, 18-month, and 24-month follow-up.Results: The psychoeducational intervention was successful in increasing compliance with vaginal dilation.Conclusions: This study is the first randomized controlled study to demonstrate the effectiveness of an intervention in increasing compliance with the use of vaginal dilators.

A medical chart review for information about sexual functioning in cervical carcinoma

Fifty medical charts from two departments of radiotherapy, one in France and the other in the United States, were reviewed to determine their utility in contributing to information about sexual functioning after treatment for cervical cancer. For both settings, useful information about the disease, its treatment and the post-treatment complications was readily available. Significant differences were found between the settings in the documentation of data about sexual function, vaginal dilator use and dilator compliance. The utility of medical records for the purpose of gathering information about sexual functioning after radiotherapy for cervical cancer was found to be significantly higher in one of the settings for several variables. Possible reasons for these findings are given along with medical charts for the promotion and study of sexual rehabilitation for patients with cervical carcinoma.