Vaginal stenosis

Vaginal stenosis is an abnormal condition in which the vagina becomes narrower and shorter due to the formation of fibrous tissue.[1][2] Vaginal stenosis can have a negative impact on sexual dysfunction, dyspareunia and make pelvic exams difficult and painful.[1] The lining of the vagina may also be thinner and drier and contain scar tissue. This condition can result in pain during sexual intercourse or a pelvic exam. Vaginal stenosis is often caused by an episiotomy, radiation therapy to the pelvis or some types of surgery.[3][4][5] Chemotherapy can also increase the likelihood of developing vaginal stenosis.[6] Vaginal stenosis can be a defect caused by congenital adrenal hyperplasia.[7] Having an episiotomy is associated with stenosis.[8]

Causes

Radiation-induced

Uterine, vaginal, rectal and cervical cancers are often treated with pelvic radiation therapy (RT). Radiation-induced vaginal stenosis can be a side effect of treatment.[9][10] Causes are external beam radiation therapy (EBRT), or brachytherapy.[1][10] It is one of the most prevalent side effects of pelvic radiation, affecting about one third of women.[11][12] Radiation-induced stenosis can be a late reaction to treatment. Damage to the vaginal epithelium causes abnormal collagen production that leads to atrophy, loss of muscle, decreased blood flow, hypoxia, and fibrosis. Pallor, adhesions, and fragility can be observed along with loss of elasticity.[1]

Congenital

The inadequate prenatal suppression of adrenal androgens leads to congenital adrenal hyperplasia. This condition can result in the vagina being affected by stenosis as a result.[7]

Treatment

Stenosis of the vagina is treated with vaginal dilator therapy, but the evidence is lacking for its efficacy.[13][14]

See also

References
  1. Morris L, Do V, Chard J, Brand AH (2 May 2017). "Radiation-induced vaginal stenosis: current perspectives". International Journal of Women's Health. 9: 273–279. doi:10.2147/IJWH.S106796. PMC 5422455. PMID 28496367.
  2. "Vaginal stenosis". TheFreeDictionary.com. Retrieved 2018-03-11.
  3. "Vaginal Outlet Stenosis Repair". www.atlasofpelvicsurgery.com. Retrieved 2018-03-11.
  4. "NCI Dictionary of Cancer Terms -Vaginal Stenosis". National Cancer Institute. Retrieved 2018-03-14. This article incorporates text from this source, which is in the public domain.
  5. Rosa, Luciana Martins da; Hammerschmidt, Karina Silveira de Almeida; Radünz, Vera; Ilha, Patrícia; Tomasi, Andrelise Viana Rosa; Valcarenghi, Rafaela Vivian; Rosa, Luciana Martins da; Hammerschmidt, Karina Silveira de Almeida; Radünz, Vera (2016). "EVALUATION AND CLASSIFICATION OF VAGINAL STENOSIS AFTER BRACHYTHERAPY". Texto & Contexto - Enfermagem. 25 (2). doi:10.1590/0104-07072016003010014. ISSN 0104-0707.
  6. http://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/How_to_Manage_Vaginal_Stenosis.pdf
  7. Merke DP, Poppas DP (December 2013). "Management of adolescents with congenital adrenal hyperplasia". The Lancet. Diabetes & Endocrinology. 1 (4): 341–52. doi:10.1016/S2213-8587(13)70138-4. PMC 4163910. PMID 24622419.
  8. Venes, Donald (2017-01-25). Taber's Cyclopedic Medical Dictionary - Episiotomy. F.A. Davis. ISBN 9780803659407.
  9. Harkenrider MM, Block AM, Alektiar KM, Gaffney DK, Jones E, Klopp A, Viswanathan AN, Small W (2017). "American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review". Brachytherapy. 16 (1): 95–108. doi:10.1016/j.brachy.2016.04.005. PMC 5612425. PMID 27260082.
  10. Morris L, Do V, Chard J, Brand AH (2017-05-02). "Radiation-induced vaginal stenosis: current perspectives". International Journal of Women's Health. 9: 273–279. doi:10.2147/IJWH.S106796. PMC 5422455. PMID 28496367.
  11. "Pelvic Physiotherapy in the Prevention of Vaginal Stenosis Secondary to the Radiotherapy; ClinicalTrials.gov". Retrieved 2018-03-11. This article incorporates text from this source, which is in the public domain.
  12. "Management of radiation induced vaginal stenosis eviQ; (Australian, evidence-based health information)". www.eviq.org.au. Retrieved 2018-03-11.
  13. Miles, Tracie; Johnson, Nick (2014-09-08). Cochrane Gynaecological, Neuro-oncology and Orphan Cancer Group (ed.). "Vaginal dilator therapy for women receiving pelvic radiotherapy". Cochrane Database of Systematic Reviews (9): CD007291. doi:10.1002/14651858.CD007291.pub3. PMC 6513398. PMID 25198150.
  14. White ID, Faithfull S (May 2006). "Vaginal dilation associated with pelvic radiotherapy: a UK survey of current practice". International Journal of Gynecological Cancer. 16 (3): 1140–6. doi:10.1111/j.1525-1438.2006.00452.x. PMID 16803497.
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