Management of radiation injuries of vulva and vagina.
BACKGROUND
Acute and late injuries of vulva and vagina are frequent and potentially serious complications in radiotherapy of gynecologic tumors. They still are reported poorly in literature.


METHODS
Based on a literature search a survey will be given of the modalities, which are used or recommended for prophylaxis or treatment of these radiation injuries. The principles of the different measures will be discussed with available study results.


RESULTS
Hygiene measures and the topical application of antimicrobial or granulation stimulating substances, which is mostly based on long standing clinical experience, are the principles of the treatment of acute reactions of vulva and vagina. The topical use of estrogen, which promotes proliferation of epithelium, is generally described in connection with treatment and prophylaxis of late radiation injuries. As a prophylaxis for the late reaction of vaginal stenosis, vaginal dilatation is recommended in literature.


CONCLUSIONS
With the exception of a few reports on estrogen, there are no data about the effectiveness of the currently used medical substances. The local application of estrogen as prophylaxis of the acute reactions will therefore be examined in a prospective study.
Fraunholz
I B
IB
Klinik für Strahlentherapie und Onkologie, Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt/Main. Fraunholz@vff.uni-frankfurt.de
Schopohl
B
B
Böttcher
H D
HD
D000208:Acute Disease; D000287:Administration, Topical; D004106:Dilatation; D004967:Estrogens / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005833:Genital Neoplasms, Female / Q000532:radiotherapy*; D006801:Humans; D006920:Hygiene; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects*; D014621:Vagina / Q000528:radiation effects; D014623:Vaginal Diseases / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D014844:Vulva / Q000528:radiation effects; D014845:Vulvar Diseases / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*
D004967:Estrogens