Vaginal Dilators – Radiotherapy

Vaginal Dilators – Radiotherapy

Introduction
Radiotherapy to the pelvis can lead to narrowing and shortening of the vagina and it may also become dryer and less elastic. This may cause problems in the future while undergoing vaginal examinations or during sexual intercourse. For this reason, your consultant has advised the use of vaginal dilators.

The dilators will help keep the vaginal muscles supple as well as preventing the vaginal walls from becoming stuck together – this should make pelvic examinations and sexual intercourse easier.

What are vaginal dilators?
Vaginal dilators are smooth, cylindrical-shaped plastic tubes in a range of four sizes. 

The tubes are easy to insert into the vagina and come with a twist-lock handle and a tube of lubricating gel, supplied in a cosmetic bag. Further supplies of lubricant can be obtained from a pharmacy or via your GP on prescription. Please ensure that you only use water-based lubricants; oil-based lubricants may irritate the vaginal wall.

When should I use the dilators?
Generally, dilation should start after your radiotherapy has finished and the side effects have settled. This can be anywhere between 2-8 weeks post treatment. 

If you wish to be sexually active during treatment, it may be useful to begin dilation earlier. Please discuss this with your Oncologist, Clinical Nurse Specialist or Therapy Radiographer.

How do I use the dilators?
We suggest that you start with the smallest size and progress to the next size when you feel ready.

Be aware of the anatomy of the pelvic organs and insert the dilator at an angle following the vagina (see diagram below)

• Choose a place and time when you feel relaxed as this will help 

• Find a comfortable position, for example lying back on your bed with knees slightly apart and bent, or stand with one foot on the ground and the other raised on the side of the bed or bath.

• Slot a clean dilator into the handle and apply some of the lubricating gel onto the dilator.

• Then separate your labia, (vaginal lips) and gently insert the end of the dilator into the vagina (only the white part, not the handle). 

• Exerting gentle pressure, move the dilator into the vagina by rotating the handle clockwise until you have gone in as far as is comfortable for you. 

• Leave this in place for about a minute or until your pelvic floor feels relaxed, then gently rotate the dilator clockwise and anti-clockwise and move from side to side then pull slowly until it is nearly out. 

• Repeat these moves for up to 10 minutes at a time, at least twice a week.

• After using the smallest dilator for a period of time when you feel comfortable use the next size up. When this one is comfortable proceed to the 3^rd largest dilator or stay at whichever size is comfortable for you.

When you have finished, remove the dilator and wash it and the handle in warm soapy water, rinse and dry well. Sometimes there can be a spot of blood on the dilator. Do not worry about this. If you experience any soreness, heavy bleeding or pain, stop using the dilator and contact the Macmillan Review Radiographers for advice on 01905 761420 

It can be useful to use the dilators in conjunction with pelvic floor exercises.  Relax the pelvic floor muscles whilst moving the dilator around but then practise gripping the dilator with your pelvic floor muscles.  A separate information sheet on how to perform pelvic floor exercises is available from the Macmillan Information and Support Radiographers or your Gynaecology/ Colorectal Clinical Nurse Specialist.

Dilation therapy may also include the use of vibrators or fingers. It may not be necessary if vaginal intercourse is resumed weekly (or more) following treatment.

You should continue with dilation on a regular basis. This may be for 1 to 2 years following treatment. Your consultant will be able to advise you about this at your follow-up appointments.

Can I have sex?
Unless your consultant has advised you otherwise, you can continue to have sex – it will help to keep the vagina healthy. You are still advised to use the dilators. 

You may notice some slight bleeding after sex, or when you remove the dilator. This is nothing to worry about. Again, should the bleeding become heavy or last a long time please contact us for advice.

Cancer and Radiotherapy Information and advice
Macmillan Information and Support Radiographer: 01905 761420

Monday – Friday 8.15am – 4.30pm

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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