Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Supportive Care in Cancer
Published in: Supportive Care in Cancer 7/2013

01-07-2013 | Original Article

Toward clinical care guidelines for supporting rehabilitative vaginal dilator use with women recovering from cervical cancer

Authors: Kimberley Cullen, Karen Fergus, Tracey DasGupta, Iwa Kong, Marg Fitch, Catherine Doyle, Lauran Adams

Published in: Supportive Care in Cancer | Issue 7/2013

Login to get access

Abstract

Purpose

Building upon the findings of a recent qualitative investigation of women’s experiences with rehabilitative vaginal dilator use, the primary goal of this article is to outline a set of preliminary clinical care recommendations that health care professionals may draw upon in addressing women’s unique experiences with vaginal dilator use including their multifaceted struggles with the procedure, possibly enhancing adherence to this practice.

Methods

Ten women participated in in-depth interviews regarding their experiences with using the dilator as prescribed by their health care providers. Following the analysis of these interviews, members of the interdisciplinary research team met to review and discuss the development of clinical care recommendations stemming from these findings.

Results

Eight care recommendations aimed at addressing the concerns expressed by the women interviewed and at improving women’s overall experiences with rehabilitative dilator use emerged: (1) introduce the dilator in a light and straightforward manner; (2) enhance dilator accessibility; (3) introduce the vaginal dilator early on in treatment; (4) emphasize health maintenance over intercourse as a benefit of dilator use; (5) explore and acknowledge women’s values and views of sexuality; (6) increase awareness and sensitivity to emotional reactions; (7) enhance psychoeducational resources for supporting vaginal dilator use; and (8) ensure consistent institutional practice when introducing the dilator.

Conclusion

The clinical care recommendations proposed here reflect the various challenges women may encounter when using the vaginal dilator—which vary from practical to, for some, profoundly emotional—and are designed to better position health care providers to help women navigate these challenges.
Literature
1.
2.
3.
Faithfull S, White I (2008) Delivering sensitive health care information: challenging the taboo of women’s sexual health after pelvic radiotherapy. Patient Educ Couns 71:228–233PubMedCrossRef
4.
Jeffries SA, Robinson JW, Craighead PS, Keats MR (2006) An effective group psychoeducational intervention for improving compliance with vaginal dilation: a randomized controlled trial. Int J Radiat Oncol 65:404–411CrossRef
5.
Brand AH, Bull CA, Cakir B (2006) Vaginal stenosis in patients treated with radiotherapy for carcinoma of the cervix. Int J Gynecol Cancer 16:288–293PubMedCrossRef
6.
Decruze SB, Guthrie D, Magnani R (1999) Prevention of vaginal stenosis in patients following vaginal brachytherapy. Clin Oncol 11:46–48CrossRef
7.
Lancaster L (2004) Preventing vaginal stenosis after brachytherapy for gynaecological cancer: an overview of Australian practices. Eur J Oncol Nurs 8:30–39PubMedCrossRef
8.
Friedman LC, Abdallah R, Schluchter M, Panneerselvam A, Kunos CA (2011) Adherence to vaginal dilation following high dose rate brachytherapy for endometrial cancer. Int J Radiat Oncol 80:751–757CrossRef
9.
Carter J, Sonoda Y, Chi DS, Raviv L, Abu-Rustum NR (2008) Radical trachelectomy for cervical cancer: postoperative physical and emotional adjustment concerns. Gynecol Oncol 111:151–157PubMedCrossRef
10.
Carter J, Goldrank D, Schover LR (2011) Simple strategies for vaginal health promotion in cancer survivors. J Sex Med 8:549–559PubMedCrossRef
11.
Denton AS, Maher J (2003) Interventions for the physical aspects of sexual dysfunction in women following pelvic radiotherapy. Cochrane Database Syst Rev (1):CD003750
12.
Miles T, Johnson N (2010) Vaginal dilator therapy for women receiving pelvic radiotherapy. Cochrane Database Syst Rev (9):CD007291
13.
Johnson N, Miles T, Cornes P (2010) Dilating the vagina to prevent damage from radiotherapy: systematic review of the literature. Bjog-Int J Obstet Gy 117:522–531CrossRef
14.
Velaskar SM, Martha R, Mahantashetty U, Badakare JS, Shrivastava SK (2007) Use of indigenous vaginal dilator in radiation induced vaginal stenosis. Indian J Occup Ther 34:3–6
15.
Jefferies H, Hoy S, McCahill R, Crichton A (2007) Guidelines on vaginal dilator use after pelvic radiotherapy. Nurs Times 103:28–29
16.
17.
White I, Faithfull S (2006) Vaginal dilation associated with pelvic radiotherapy: a UK survey of current practice. Int J Gynecol Cancer 16:1140–1146PubMedCrossRef
18.
Schover LR, Fife M, David M, Gershenson DM (1989) Sexual dysfunction and treatment for early stage cervical cancer. Cancer 63:204–212PubMedCrossRef
19.
Bruner DW, Lanciano R, Keegan M, Corn B, Martin E, Hanks GE (1993) Vaginal stenosis and sexual function following intracavitary radiation for the treatment of cervical and endometrial cancer. Int J Radiat Oncol 27:825–830CrossRef
20.
Punt L (2011) Patient compliance with the use of vaginal dilators following pelvic radiotherapy for a gynecological cancer. J Radiother Pract 10:13–25
21.
Stilos K, Doyle C, Daines P (2008) Addressing the sexual health needs of patients with gynecologic cancers. Clin J Oncol Nurs 12:457–463PubMedCrossRef
22.
Katz A (2005) The sounds of silence: sexuality information for cancer patients. J Clin Oncol 23:238–241PubMedCrossRef
23.
Cullen K, Fergus K, DasGupta T, Fitch M, Doyle C, Adams L (2012) From “sex toy” to intrusive imposition: a qualitative examination of women’s experiences with vaginal dilator use following treatment for gynecological cancer. J Sex Med 9:1162–1173PubMedCrossRef
24.
Glaser BG, Strauss A (1967) The discovery of grounded theory: strategies for qualitative research. Aldine, Chicago
25.
Juraskov I, Butow P, Robertson L, Sharpe L, McLeod C, Hacker N (2003) Post-treatment sexual adjustment following cervical and endometrial cancer: a qualitative insight. Psycho-Oncol 12:267–279CrossRef
26.
Guglietti CL, Rosen B, Murphy KJ, Laframboise S, Dodge J, Ferguson S, Katz J, Ritvo P (2010) Prevalence and predictors of posttraumatic stress in women undergoing an ovarian cancer investigation. Psychol Serv 7(4):266–74.24CrossRef
27.
Urbaniec OA, Collins K, Denson LA, Whitford HS (2011) Gynecological cancer survivors: assessment of psychological distress and unmet supportive care needs. J Psychosoc Oncol 29(5):534–551PubMedCrossRef
Metadata
Title
Toward clinical care guidelines for supporting rehabilitative vaginal dilator use with women recovering from cervical cancer
Authors
Kimberley Cullen
Karen Fergus
Tracey DasGupta
Iwa Kong
Marg Fitch
Catherine Doyle
Lauran Adams
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 7/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-013-1726-6

Other articles of this Issue 7/2013

Supportive Care in Cancer 7/2013 Go to the issue

Original Article

Symptom burden in palliative care patients: perspectives of patients, their family caregivers, and their attending physicians

Original Article

Outcomes in critically ill chronic lymphocytic leukemia patients

Original Article

A cross-sectional survey of pain in palliative care in Portugal

Original Article

Relationships between hepatitis B infection status and liver dysfunction after chemotherapy of lung cancer patients in mainland China

Original Article

Pancreatic cancer and supportive care—pancreatic exocrine insufficiency negatively impacts on quality of life

Original Article

The effect of aerobic exercise on metabolic and inflammatory markers in breast cancer survivors—a pilot study
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits