Effectiveness of the use of silicone penile prosthesis in the prevention of vaginal stenosis after high dose rate brachytherapy
Dias, M1; Custódio, LL2; Patrício, JJS2; Bragante, KC3; Toriy, AM4; Souza, CPF1; Mozzini, CB3
1: Oncology Research Centre CEPON, Brazil; 2: University of Southern Santa Catarina, Brazil; 3: Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil; 4: University of the State of Santa Catarina, Brazil
Objective: To verify the effectiveness and adhesion of women to the use of silicone penile prosthesis (SPP) in the prevention of vaginal stenosis after gynecological cancer treatment with High Dose Rate Brachytherapy (HDR).
Material and methods: Retrospective analysis of the medical records of women diagnosed with gynecological cancer, attended at the physiotherapy service after HDR, at a Cancer Center in Southern Brazil, between July 2016 and September 2017. For the collection of sociodemographic and clinical data, a separate form was used.. For the assessment of vaginal stenosis, the Common Criteria for Adverse Events version 3.0 (CTCAEv3.0) was used, supplemented by gynecological examination. According to the medical record description, women received the SPP for home use on the last day of HDR (3x per week for 20 minutes). The adherence was evaluated based on the patient’s self-report. It was considered adherent, patients who used the SPP at least once a week for 20 minutes.
Results: We analyzed the charts of 84 women with a mean age of 54.77 years (± 13.06). Cervical cancer was the most common, observed in 72.6% (n = 61) of the women, with the most frequent FIGO staging being IIB (31.60%, n = 25) and IIIB (27.80%; n = 22). The majority of the women were married or were in stable union (60,30%, n = 55). Active sex life was reported by 36.10% (n = 30) of the sample and vaginal stenosis was verified in 35.4% (n = 29) women. Adherence to the SPP was verified in 41,7% (n=35) of the patients. When compared adherent with non-adherent women, there was a difference statistically significant on the presence of vaginal stenosis (p=0,05), where women who didn’t use the prosthesis have a higher degree of stenosis (1.88 ± 0.88) compared to those who used it (1.31 ± 0.63)Conclusion: It was observed that the effectiveness of SPP to prevent post-HDR vaginal stenosis depends on a patient adherence. In this research was found a moderate patient adherence and when SPP was used between one and three times per week prevented post-HDR vaginal stenosis. Vaginal stenosis is still one of the major sequels of gynecological cancer treatment. The need for interventions for guidance and prevention of stenosis is indicated immediately after the completion of HDR.
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