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.

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

CONCLUSION

Use of a rigid dilator in an attempt to lengthen a heavily radiated vaginal cuff may be hazardous.