Risks of rigid dilation for a radiated vaginal cuff: two related rectovaginal fistulas.
BACKGROUND
Dyspareunia secondary to significant radiation fibrosis of the vagina is a difficult clinical problem. The benefit of vaginal dilator therapy in such patients is unclear.


METHODS
We report two patients who had attempted dilation and elongation of a small, fibrotic, heavily radiated vagina and subsequently developed a rectovaginal fistula.


CONCLUSIONS
Use of a rigid dilator in an attempt to lengthen a heavily radiated vaginal cuff may be hazardous.
Department of Obstetrics and Gynecology, University of South Florida, Tampa, Florida, USA. macevedo@hsc.usf.edu
Mitchel S
MS
Hoffman
Katie E
KE
Wakeley
Richard J
RJ
Cardosi
D000328:Adult; D004106:Dilatation / Q000009:adverse effects* / Q000295:instrumentation; D004414:Dyspareunia / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011832:Radiation Injuries / Q000150:complications; D012006:Rectovaginal Fistula / Q000209:etiology*; D012306:Risk; D014621:Vagina / Q000473:pathology / Q000528:radiation effects*