Introduction/Background VS is a well-described consequence of pelvic RT, with spectrum of changes evolving over several years. Strong risk factors for VS include RT dose and volume of vagina irradiated. Resultant vaginal changes not only interfere with sexual function but also make the surveillance challenging. Although the vaginal dilators are frequently prescribed but the frequency and duration of dilator use is still variable and no standard protocol exist.

This study was planned to update our current state of knowledge concerning VS and VDT among patients treated with pelvic radiation for cervical cancer.

Methodology Open-label RCT of 120 women, stage I-IIIB, aged 25–65 years, using VD twice daily for 10 minutes (60 Group 1) vs vaginal dilator sed twice daily for 60 minutes (60 Group 2) to assess the incidence and severity of vaginal stenosis after radiotherapy at Gynae oncology unit at KEMU, from October/2018 to September/2023. The main outcome measure was vaginal stenosis assessed using the Common Terminology Criteria for Adverse Events (CTCAE) scale and percental changes in vaginal volume. The women were evaluated at four different times: shortly after the end of radiotherapy, and four, eight, and 12 months after the beginning of the intervention.

Results The mean age of women was 40years, 60 percent were premenopausal and 75 percent had stage IIB-IIIB tumors. The mean reduction in vaginal volume in Group 1 was 40 percent, with significantly improved vaginal length in group 2 throughout the intervention period. There was worsening of vaginal stenosis evaluated by CTCAE scale after 1 year in group 1(p < 0.01), except for the users of vaginal dilators in group 2.

Conclusion Women who used vaginal dilators for increased duration up to 60 minutes twice daily had a lower frequency and severity of vaginal stenosis assessed by the CTCAE scale after one year of treatment.

Disclosures None.