Vaginal care following Pelvic Radiotherapy (anal cancer)

One of the possible side effects of pelvic radiotherapy is the formation of scar tissue within the vagina. This can cause the vagina to become shorter or narrower and the tissue to become dryer and less elastic. As a result, it can become more difficult to be examined and can make sexual intercourse uncomfortable.

To help minimise this problem, you have been given a dilator kit. This kit contains a range of plastic tubes of various sizes which dilate or stretch the vagina. This helps the muscles of the vagina to relax and prevents scar tissue developing. The dilators come in a range of sizes. You will be advised to start with the smallest size and increase the size only if it feels comfortable. It is advisable to use a water-soluble lubricant such as KY jelly. This will help to keep the lining of your vagina moist and supple.

We recommend that you start using the dilators four to six weeks after completing your radiotherapy treatment (or before if the soreness has settled). The dilators should be used at least three times a week and current evidence suggests that the development of scar tissue is best prevented by using the dilator indefinitely.

Once you are sexually active again, the dilators need not be used on the days that you have sexual intercourse. Slight bleeding or spotting may occur during intercourse or after using the dilators during the first few weeks. If the bleeding persists or is unduly heavy, it is advisable to contact your doctors or specialist nurse.

Using a vaginal dilator

Place the lubricating cream on the rounded end of the dilator and around the entrance to the vagina.

1. You can either lie on your back with your knees slightly bent, stand with one foot on the side of a bath or stool or use whilst in a shower/bath.
2. Insert the dilator gently into the vagina as far as is comfortable. The dilator should be inserted and withdrawn in a forward and backward motion, then a left to right motion and if possible, gently rotating the dilator in a small circular motion. Withdraw and reinsert the dilator for a total of five to ten minutes.
3. Remove the dilator slowly (rotating in a clockwise/anticlockwise movement if possible)
4. Clean the dilator with warm, soapy water and rinse thoroughly.

Sometimes following radiotherapy, sexual intercourse may feel different or uncomfortable. If you are experiencing any discomfort or would just like to talk through some of these changes then please contact us on the number below. Vaginal dilation is of course optional but we like to give you this information to enable you to decide if it is something that you feel able to do.

When treatment has finished

Reaching the end of your treatment can be a difficult time. You will feel relieved that your treatment is finally over but you may also experience a feeling of ‘what now’? You may find that you miss the security of being seen at the hospital on a regular basis. Some people will also find that it takes rather longer than they expect to recover fully from their treatment.

For more detailed information please see the following Macmillan information booklet:

• Life After Cancer Treatment
• Your feelings after cancer treatment

You may like to consider joining a support group where you can share your experiences with others. Maggie’s Centre, Cambridge offers a 6 week psychoeducational course

Further Information and support

Macmillan Cancer information and support service

This is located in the Oncology department. This is a drop in service.

The Macmillan information and support team offer support, advice and information to anyone affected by cancer. The service can provide practical and emotional support as well as help and advice with grant applications and referral and signposting to benefits advice. You will have been given the contact number for the Cancer Navigator for your team and may well have met them along the way. They are there to also help you.

The Maggies Wallace Cancer Support centre (opens in a new tab)

This is a warm and welcoming support centre, where information, support and attention to the practical, physical and psychological needs of cancer patients and those who care for them are provided free of charge. Complementary therapies, practical advice on healthy eating, hot flush management and much more is available.

Lower GI Clinical Nurse Specialist 01223 348126

Privacy & dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.