Vaginal stenosis following irradiation therapy for carcinoma of the cervix uteri

Eighty-eight per cent of 221 indigent women treated with irradiation for invasive carcinoma of cervix uteri acquired some degree of vaginal stenosis. This complication is caused by denudation of the vaginal epithelium and circumferential fibrosis of the perivaginal tissues. For a given patient, the maximum amount of obliteration occurred within 1 to 8 months after completion of radiation treatment. The majority sustained maximum stenosis in 3 months or less. Patients failed to use preventive measures through psycho-sexual reasons or fear of spreading or aggravating the cancerous disease. To minimize or prevent the complication, measures to dilate the vagina and administration of estrogens to promote epithelization and increased vascularity of the tissues are recommended before radiation treatment is completed or shortly thereafter.