MANAGEMENT OF RADIATION INJURIES OF VULVA AND VAGINA

Background: Acute and late injuries of vulva and vagina are frequent a nd potentially serious complications in radiotherapy of gynecologic tu mors. They still are reported poorly in literature. Methods: Based on a literature search a survey will be given of the modalities, which ar e used or recommended for prophylaxis or treatment of these radiation injuries. The principles of the different measures will be discussed w ith available study results. Results: Hygiene measures and the topical application of antimicrobial or granulation stimulating substances, w hich is mostly based on long standing clinical experience, are the pri nciples of the treatment of acute reactions of vulva and vagina. The t opical use of estrogen, which promotes proliferation of epithelium. is generally described in connection with treatment and prophylaxis of l ate radiation injuries. As a prophylaxis for the late reaction of vagi nal stenosis, vaginal dilatation is recommended in literature. Conclus ions: With the exception of a few reports on estrogen, there are no da ta about the effectiveness of the currently used medical substances. T he local application of estrogen as prophylaxis of the acute reactions will therefore be examined in a prospective study.