Prevention of vaginal stenosis after treatment for gynaecological cancer

Background Radiotherapy to the pelvis is an effective treatment for gynaecological cancers. This treatment, however, can result in vaginal stenosis, which may lead to dyspareunia, affecting psychosocial health and intimate relationships. It can also result in painful vaginal examinations and even preclude a full clinical examination, which is often an essential component for follow-up care. Several nurse-led initiatives were implemented across Western Australian Gynaecological Cancer Services (WAGCS) during 2008-2009 to prevent development of vaginal stenosis including the Prevention of vaginal stenosis clinical pathway. Aim To ascertain whether implementation of the Prevention of vaginal stenosis clinical pathway resulted in increased knowledge of vaginal stenosis and use of vaginal dilators in accordance with best practice. Method A clinical audit of women who received care before (n =20) and after (n= 18) implementation of the clinical pathway. Results The best practice Prevention ·of vaginal stenosis clinical pathway led to better understanding of vaginal stenosis and increased use of vaginal dilators in women at risk. Conclusion Use of evidence-based support and education can prevent or ameliorate some of the known debil itating side effects of cancer treatment