Sarcoma botryoides is a variant of embryonal rhabdomyosarcoma. This malignant tumor originates from muscle progenitor cells and although it is highly malignant, cure rates exceed 90%.1 While rhabdomyosarcoma is the most common soft tissue malignancy in children, vaginal presentation is rare.2 The average age of diagnosis of vaginal rhabdomyosarcoma is 21 months of age. Treatment consists of chemotherapy combined with local radiation to achieve local tumor control while preserving organ function.1 Sequelae of vaginal radiation therapy in this age group have not been well defined. However, vaginal stenosis is a known result of local radiation therapy in adult women treated for a variety of pelvic cancers. In adults, vaginal dilation is the primary method of prevention and treatment.3 An 18-month-old child presented with vaginal bleeding and was diagnosed with vaginal rhabdomyosarcoma. She underwent unilateral oophorectomy for fertility preservation prior to initiating a 40-week chemotherapy course. During weeks 24 to 26 of chemotherapy, she underwent vaginal brachytherapy radiation treatment. Six weeks following completion of radiation, vaginoscopy was performed with placement of non-latex 18 French (6mm) foley catheter to prevent vaginal stricture. When removed, vaginal patency was normal for her age with no vaginal erosion noted. Use of a soft, flexible, non-latex catheter provided a comfortable method of vaginal stricture prevention without need for vaginal dilation in a young child. Picture 1. Foley catheter vaginal stent can be visualized just proximal to the hymen. Three 5-0 prolene sutures were used to gently secure it in place. Picture 2. Following removal of the stent, normal vaginal patency and mucosa are visualized 1Kirsch CH, Goodman, M, Esiashvili N. Outcome of female pediatric patients diagnosed with genital tract rhabdomyosarcoma based on analysis of cases registered in SEER database between 1973 and 2006. Am J Clin Oncol (2012); 37:472Deligeoroglou E, Tsimaris P, Creatsa M, et al. Application of creatsas vaginoplasty after radical surgical treatment of sarcoma botryoides. J Pediatric Adolesc Gynecol 27 (2014); 93-95.3Miles T, Johnson N. Vaginal dilator therapy for women receiving pelvic radiotherapy. Cochrane Database of Systematic Reviews (2014), Issue 9. Art No: CD007291.