title: Graft-versus-Host Disease-Associated Vulvovaginal Symptoms after Bone Marrow Transplantation.
abstract: We conducted a retrospective review to assess the prevalence of graft-versus-host disease (GVHD)-associated gynecologic conditions among bone marrow transplantation (BMT) patients at City of Hope Medical Center. We calculated the associations among the estimated risks of various gynecologic complications, including vaginal stenosis, by performing chi-square tests and t-test statistics. Between 2010 and 2014, 180 patients were referred to the gynecologic clinic after their BMT. One hundred twenty-four patients (69%) had GVHD; among these patients, 51 (41%) experienced dyspareunia and 43 (35%) had vaginal stenosis. GVHD patients were significantly more likely to have vaginal stenosis (P < .0001), more likely to have used a vaginal dilator (P = .0008), and less likely to have urinary incontinence (UI) than those without GVHD (P < .001). There was no difference in developing pelvic organ prolapse (POP) in patients with or without GVHD (P = .4373). GVHD was a common complication after allogenic BMT. Patients with BMT were more likely to have vulvovaginal symptoms, such as dyspareunia and pelvic pain. Patients with GVHD are at high risk for vaginal stenosis requiring the use of a vaginal dilator. However, they are at low risk for developing UI and POP.
authors.affiliation: Division of Gynecologic Oncology, Department of Surgery, City of Hope Medical Center, Duarte, California. Electronic address: chchung@coh.org.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Chung
authors.affiliation: Division of Gynecologic Oncology, Department of Surgery, City of Hope Medical Center, Duarte, California.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Sargent
authors.affiliation: Department of Population Sciences, Beckman Research Institute, City of Hope Medical Center, Duarte, California.
authors.forename: Nadia T
authors.initials: NT
authors.lastname: Chung
authors.affiliation: Department of Population Sciences, Beckman Research Institute, City of Hope Medical Center, Duarte, California.
authors.forename: James V
authors.initials: JV
authors.lastname: Lacey
authors.affiliation: Division of Gynecologic Oncology, Department of Surgery, City of Hope Medical Center, Duarte, California.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Wakabayashi
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D014621:Vagina / Q000473:pathology*; D014848:Vulvovaginitis / Q000209:etiology*
keywords: Bone marrow transplant; Graft-versus-host disease; Vaginal stenosis; Vulvovaginal symptoms