978:
642:
328:
Some studies have suggested positive patient outcomes when VDT was coupled with a longer dilation duration. Using VDT with meditation and soothing music has also been shown to increase effectiveness, though evidence for this is not high grade. Regular psychosocial support and regular follow up visits
278:
The lack of a well-established grading scale has potentially led to poor vaginal dilator therapy and long-term vaginal stenosis. Vaginal stenosis is most often diagnosed with subjective parameters. These subjective parameters in combination with the variety of different grading scales used, cannot be
274:
based on three grades based upon shortening or narrowing of the vagina, its interference with physical examination, and its interference with use of tampons or sexual activity. However, this scale is not specific to just vaginal injuries alone. The LENT-SOMA grading scale for vaginal stenosis is
229:, which are surgical incisions sometimes used to assist childbirth, can lead to narrowing of the vaginal opening and long-term dyspareunia. There is approximately 13% chance of experiencing dyspareunia for at least 6 months after having undergone a routine episiotomy. When the tissue from the
1284:
de Morais
Siqueira T, Derchain S, Juliato CR, Pinto E Silva MP, Machado HC, Brito LG (2022). "Vaginal stenosis in women with cervical or endometrial cancer after pelvic radiotherapy: a cross-sectional study of vaginal measurements, risk for sexual dysfunction and quality of life".
112:
Lasting effects of vaginal stenosis could include impacts on psychological well-being in addition to physical limitations. Symptoms can worsen from post treatment ovarian failure or menopausal status, leading to reduced lubrication and increased thinning of the vaginal tissue.
275:
based on the assessment of subjective symptoms, analytical tests, and observed clinical manifestations. This scale was invented by the
European Organization for the Research and Treatment of Cancer (EORTC) along with the Radiation Therapy Oncology Group (RTOG) from the US.
364:, but there are currently not many studies on its effect on people with radiotherapy-induced vaginal stenosis. A 2020 study demonstrated an improvement in vaginal length as well as the Vaginal Health Index, though more studies are needed to establish efficacy.
185:, and fragility can be observed along with loss of elasticity. These can all contribute to sexual dysfunction that affects more than half of gynecological cancer survivors. Some women who have reduced ovarian function and an estrogen shortage after
2482:
2467:
316:
Although there is no high level evidence, many guidelines and reviews suggest the use of vaginal dilator therapy after pelvic radiation therapy. It is believed that this therapy stretches vaginal tissues and the vaginal canal, leading to
407:). In addition, symptoms may not occur until a year after radiation therapy and can increase in severity over the course of three years. Vaginal stenosis may also be underreported due to stigma and discomfort around discussion of
300:
are smooth, cylindrical-shaped devices that promote stretching and relaxation of the vaginal tissue. Vaginal dilator therapy requires a consistent routine and may cause physical and/or psychological discomfort, which makes
233:
does not heal properly, complications can include mucosal damage and scarring, which can contribute to the development of vaginal stenosis. Vaginal stenosis is the most common post-operative complication in people with
1647:
103:. This can lead to challenges such as difficulty engaging in intercourse and decreased sex drive. Severe forms of vaginal stenosis can be associated with a complete inability to participate in sexual intercourse.
353:
helps treat vaginal stenosis by retaining moisture to promote vaginal tissue repair. There are currently no known contraindications and is commonly used in clinical practice due to its high safety profile.
2513:
1640:
1141:
Wang LC, Poppas DP (2017). "Surgical outcomes and complications of reconstructive surgery in the female congenital adrenal hyperplasia patient: What every endocrinologist should know".
395:-induced vaginal stenosis varies widely, ranging from 1.2% to 88%. This is due to past studies being limited to small groups as well as variability due to personal factors such as:
379:
recurrence. Similarly, there has been one study conducted that suggests people treated with high dose radiation therapy have a lower likelihood of responding to estrogen treatment.
1238:
Haddad NC, Soares Brollo LC, Pinho
Oliveira MA, Bernardo-Filho M (2021). "Diagnostic Methods for Vaginal Stenosis and Compliance to Vaginal Dilator Use: A Systematic Review".
1633:
157:. Radiation-induced vaginal stenosis can be a side effect of treatment. It is one of the most prevalent side effects, affecting about one third of people undergoing pelvic
313:
are hard to quantify and control for. Optimal duration of vaginal dilator therapy and its improvements on sexual function and cancer-related outcomes remain unclear.
267:
1021:"Role of vaginal pallor reaction in predicting late vaginal stenosis after high-dose-rate brachytherapy in treatment-naive patients with cervical cancer"
262:
There are currently several grading scales that exist to assess vaginal stenosis but none have been well established. Two common grading scales are the
270:(CTCAE) v4.0 and the Late Effects in Normal Tissues-Subjective, Objective, Management and Analytic Score (LENT-SOMA). The CTCAE v4.0 assesses vaginal
995:
700:
109:, scarring, and damage to the vaginal tissue due to vaginal stenosis can lead to dryness, inflammation, and decreased elasticity of the tissue.
2434:
1571:"Results of a Phase I-II Study on Laser Therapy for Vaginal Side Effects after Radiotherapy for Cancer of Uterine Cervix or Endometrium"
2078:
1619:
Miles T. International guidelines on vaginal dilation after pelvic radiotherapy. Brook Hill, Woodstock, Oxon: Owen
Mumford Ltd. 2012.
920:"American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review"
2248:
1767:
585:
213:
is also associated with a higher risk of vaginal stenosis. There is also a high correlation between vaginal stenosis and vaginal
279:
interchanged in clinical practice. This makes it harder to properly diagnose the condition and establish a standard treatment.
1862:
239:
235:
88:
84:
1380:
White ID, Faithfull S (2006). "Vaginal dilation associated with pelvic radiotherapy: a UK survey of current practice".
601:
2375:
2518:
201:
received, several risk factors can contribute to the development of vaginal stenosis. Women over the age of 50 with
99:
Common indicators of vaginal stenosis include pain and bleeding during sexual intercourse along with other types of
2370:
2103:
1800:
400:
150:
2419:
1988:
869:"Pelvic Radiation Therapy Induced Vaginal Stenosis: A Review of Current Modalities and Recent Treatment Advances"
781:"Maintaining sexual health throughout gynecologic cancer survivorship: A comprehensive review and clinical guide"
263:
305:
to treatment difficult. It may be difficult to evaluate the efficacy of vaginal dilation therapy as measures of
1755:
428:
412:
388:
247:
325:. Some studies have even suggested correlations between VDT and preventing risk of severe vaginal stenosis.
1068:
Jiang H, Qian X, Carroli G, Garner P, et al. (Cochrane
Pregnancy and Childbirth Group) (February 2017).
2303:
2253:
2209:
1867:
2281:
1857:
1696:
1656:
1331:
Miles T, Johnson N, et al. (Cochrane
Gynaecological, Neuro-oncology and Orphan Cancer Group) (2014).
2286:
2140:
2083:
2008:
1946:
1807:
996:"Management of radiation induced vaginal stenosis eviQ; (Australian, evidence-based health information)"
47:
becomes narrower and shorter due to the formation of fibrous tissue. Vaginal stenosis can contribute to
83:
can also increase the likelihood of developing vaginal stenosis. Vaginal stenosis can also result from
1117:
217:
reactions, which is when the mucous membranes thin and dry out, leading to inflammation and fibrosis.
2298:
1723:
302:
550:
2409:
2348:
2204:
182:
972:
for "Pelvic
Physiotherapy in the Prevention of Vaginal Stenosis Secondary to the Radiotherapy" at
2276:
2233:
2199:
2135:
2098:
2003:
1953:
1936:
1904:
1894:
1795:
1750:
1706:
1701:
1551:
1453:
1405:
1310:
1263:
1166:
973:
420:
408:
242:
in infancy or childhood. Vaginal stenosis can be an immediate complication or may arise later in
100:
60:
56:
48:
1569:
Perrone AM, Tesei M, Ferioli M, De
Terlizzi F, Della Gatta AN, Boussedra S, et al. (2020).
625:
59:
may also be thinner and drier and contain scar tissue. This condition can result in pain during
2291:
2189:
1872:
1760:
1602:
1543:
1502:
1445:
1397:
1362:
1302:
1255:
1215:
1158:
1099:
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761:
682:
581:
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532:
452:
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372:
206:
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186:
170:
158:
146:
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1973:
1740:
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1389:
1352:
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1197:
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1089:
1081:
1040:
1032:
939:
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890:
880:
800:
792:
751:
743:
672:
659:
Rosa LM, Hammerschmidt KS, RadĂĽnz V, Ilha P, Tomasi AV, Valcarenghi RV, et al. (2016).
522:
512:
368:
346:
2221:
2164:
2073:
2037:
1978:
1919:
1777:
1688:
424:
396:
350:
338:
310:
306:
297:
293:
210:
202:
142:
918:
Harkenrider MM, Block AM, Alektiar KM, Gaffney DK, Jones E, Klopp A, et al. (2017).
161:. Radiation-induced stenosis can be a late reaction to treatment. Damage to the vaginal
2396:
2258:
2150:
2110:
2088:
1924:
1787:
1772:
1716:
1597:
1570:
1497:
1472:
1428:
Liu M, Juravic M, Mazza G, Krychman ML (2021). "Vaginal
Dilators: Issues and Answers".
1357:
1332:
1210:
1185:
1094:
1069:
1045:
1020:
944:
919:
895:
868:
805:
780:
756:
731:
527:
500:
357:
130:
126:
1201:
1019:
Yoshida K, Yamazaki H, Nakamura S, Masui K, Kotsuma T, Akiyama H, et al. (2015).
747:
2507:
2404:
1929:
1914:
1877:
1812:
1730:
1538:
1521:
1457:
1393:
1314:
1267:
982:
646:
404:
342:
154:
138:
2476:
1555:
1409:
1170:
2323:
2176:
2055:
1963:
1941:
1882:
1817:
1745:
1660:
1522:"Dynamic role of hyaluronan (HYA) in connective tissue activation and inflammation"
1348:
1085:
677:
660:
251:
80:
968:
935:
225:
Several types of surgical procedures are hypothesized to cause vaginal stenosis.
2328:
2243:
2216:
2180:
2126:
2047:
2032:
1958:
1845:
1822:
1711:
1154:
796:
436:
243:
134:
64:
52:
1488:
1471:
Damast S, Jeffery DD, Son CH, Hasan Y, Carter J, Lindau ST, Jhingran A (2019).
1441:
1298:
1251:
189:
can have an even thinner vaginal mucosal lining that worsens vaginal stenosis.
2491:
2429:
2313:
2263:
2185:
2093:
2024:
1909:
1735:
1036:
318:
271:
254:, vaginal stenosis has been shown to be a common post-surgical complication.
230:
226:
162:
76:
32:
1473:"Literature Review of Vaginal Stenosis and Dilator Use in Radiation Oncology"
885:
686:
2318:
2308:
2194:
1664:
1587:
361:
1606:
1506:
1449:
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1366:
1306:
1259:
1219:
1162:
1103:
1054:
953:
904:
814:
765:
536:
329:
should occur in order to support this therapy and optimize the treatment.
2459:
1547:
2424:
2130:
517:
376:
322:
174:
661:"Evaluation and Classification of Vaginal Stenosis After Brachytherapy"
166:
106:
375:-induced vaginal stenosis due to concerns around an increased risk of
197:
While the severity of vaginal stenosis depends largely on the type of
2486:
2471:
2065:
1836:
214:
178:
72:
44:
1333:"Vaginal dilator therapy for women receiving pelvic radiotherapy"
981:
This article incorporates text from this source, which is in the
779:
Huffman LB, Hartenbach EM, Carter J, Rash JK, Kushner DM (2016).
645:
This article incorporates text from this source, which is in the
1629:
732:"Management of adolescents with congenital adrenal hyperplasia"
1070:"Selective versus routine use of episiotomy for vaginal birth"
501:"Radiation-induced vaginal stenosis: current perspectives"
443:
is not well-reported, but is estimated to be up to 80%.
1143:
The
Journal of Steroid Biochemistry and Molecular Biology
296:
therapy (VDT), but evidence is lacking for its efficacy.
321:
cell growth, and decreasing potential circumferential
246:. Additionally, in people undergoing a male-to female
2449:
205:
tend to have a higher risk of vaginal stenosis from
2453:
2395:
2388:
2363:
2230:
2163:
2119:
2064:
2046:
2023:
1891:
1844:
1835:
1786:
1687:
1678:
1671:
360:has been shown to improve symptoms for people with
26:
21:
626:"NCI Dictionary of Cancer Terms -Vaginal Stenosis"
577:Taber's Cyclopedic Medical Dictionary - Episiotomy
165:causes abnormal collagen production that leads to
2514:Noninflammatory disorders of female genital tract
1279:
1277:
292:Stenosis of the vagina is typically treated with
55:and make pelvic exams difficult and painful. The
862:
860:
858:
856:
854:
852:
850:
848:
846:
844:
349:treatment but further investigation is needed.
1233:
1231:
1229:
842:
840:
838:
836:
834:
832:
830:
828:
826:
824:
494:
492:
490:
488:
268:Common Terminology Criteria for Adverse Events
1641:
1382:International Journal of Gynecological Cancer
1326:
1324:
486:
484:
482:
480:
478:
476:
474:
472:
470:
468:
8:
725:
723:
1423:
1421:
1419:
1337:The Cochrane Database of Systematic Reviews
1118:"Episiotomy Complications and Side Effects"
1074:The Cochrane Database of Systematic Reviews
399:, age, dose and mode of radiation therapy (
2450:
2392:
2169:
1850:
1841:
1684:
1675:
1648:
1634:
1626:
499:Morris L, Do V, Chard J, Brand AH (2017).
79:, or other forms of surgical procedures.
18:
1596:
1586:
1537:
1496:
1356:
1209:
1093:
1044:
943:
894:
884:
804:
755:
676:
526:
516:
431:of vaginal stenosis in people undergoing
415:of vaginal stenosis in people undergoing
736:The Lancet. Diabetes & Endocrinology
337:Recent treatment advances include local
169:, loss of muscle, decreased blood flow,
505:International Journal of Women's Health
464:
67:. Vaginal stenosis is often caused by
43:is an abnormal condition in which the
1184:Li JS, Crane CN, Santucci RA (2021).
7:
2435:Persistent genital arousal disorder
1287:International Urogynecology Journal
248:gender-affirming surgical procedure
867:VarytÄ— G, BartkeviÄŤienÄ— D (2021).
14:
2249:Hypoactive sexual desire disorder
1768:Ovarian hyperstimulation syndrome
1202:10.1590/S1677-5538.IBJU.2020.0338
665:Texto & Contexto - Enfermagem
367:There are limited studies around
1539:10.1046/j.1365-2796.1997.00173.x
1394:10.1111/j.1525-1438.2006.00452.x
976:
701:"How to Manage Vaginal Stenosis"
640:
602:"Vaginal Outlet Stenosis Repair"
1025:Journal of Gynecologic Oncology
151:external beam radiation therapy
1863:Dysfunctional uterine bleeding
1349:10.1002/14651858.CD007291.pub3
1240:The Journal of Sexual Medicine
1186:"Vaginoplasty tips and tricks"
1086:10.1002/14651858.CD000081.pub3
678:10.1590/0104-07072016003010014
240:genital reconstructive surgery
236:congenital adrenal hyperplasia
145:are often treated with pelvic
89:congenital adrenal hyperplasia
85:genital reconstructive surgery
1:
1520:Gerdin B, Hällgren R (1997).
1145:. Genetic Steroid Disorders.
1122:www.birthinjuryhelpcenter.org
748:10.1016/S2213-8587(13)70138-4
288:Vaginal Dilator Therapy (VDT)
1959:Menorrhagia (hypermenorrhea)
1930:Polymenorrhea (epimenorrhea)
1526:Journal of Internal Medicine
1477:Practical Radiation Oncology
936:10.1016/j.brachy.2016.04.005
730:Merke DP, Poppas DP (2013).
606:www.atlasofpelvicsurgery.com
2376:Pelvic inflammatory disease
1155:10.1016/j.jsbmb.2016.03.021
797:10.1016/j.ygyno.2015.11.010
2535:
2371:Pelvic congestion syndrome
1801:Fallopian tube obstruction
1489:10.1016/j.prro.2019.07.001
1442:10.1016/j.sxmr.2019.11.005
1299:10.1007/s00192-021-04798-8
1252:10.1016/j.jsxm.2020.12.013
362:menopausal genital atrophy
2420:Vestibular papillomatosis
2339:
2272:
2172:
1999:
1989:Metropathia haemorrhagica
1853:
1190:International Braz J Urol
1037:10.3802/jgo.2015.26.3.179
630:National Cancer Institute
264:National Cancer Institute
1756:Follicular cyst of ovary
886:10.3390/medicina57040336
423:and 60% for people with
2254:Sexual arousal disorder
2210:Candidal vulvovaginitis
1868:Endometrial hyperplasia
1588:10.3390/cancers12061639
1430:Sexual Medicine Reviews
419:is 50% for people with
371:therapy in people with
1697:Endometriosis of ovary
966:Clinical trial number
574:Venes D (2017-01-25).
2141:Vesicouterine fistula
2084:Cervical incompetence
2009:Recurrent miscarriage
1947:Premenstrual syndrome
1808:Fallopian tube cancer
555:TheFreeDictionary.com
2299:Rectovaginal fistula
1724:Poor ovarian reserve
785:Gynecologic Oncology
518:10.2147/IJWH.S106796
149:(RT), most commonly
57:lining of the vagina
2349:Postcoital bleeding
2277:Urogenital fistulas
2205:Bacterial vaginosis
1858:Asherman's syndrome
221:Surgical procedures
2234:Sexual dysfunction
2200:Atrophic vaginitis
2136:Retroverted uterus
2099:Female infertility
2079:Cervical dysplasia
2004:Female infertility
1796:Female infertility
1751:Corpus luteum cyst
1707:Ovulatory disorder
1702:Female infertility
974:ClinicalTrials.gov
551:"Vaginal stenosis"
421:endometrial cancer
409:sexual dysfunction
101:sexual dysfunction
95:Signs and symptoms
61:sexual intercourse
49:sexual dysfunction
2501:
2500:
2447:
2446:
2443:
2442:
2384:
2383:
2359:
2358:
2292:Obstetric fistula
2190:Vaginal discharge
2159:
2158:
2104:Cervical stenosis
2019:
2018:
1873:Endometrial polyp
1831:
1830:
1761:Theca lutein cyst
1149:(Pt A): 137–144.
453:Vaginal anomalies
441:colorectal cancer
433:radiation therapy
417:radiation therapy
207:radiation therapy
199:radiation therapy
159:radiation therapy
147:radiation therapy
122:Radiation-induced
69:radiation therapy
38:
37:
16:Medical condition
2526:
2451:
2415:Kraurosis vulvae
2410:Bartholin's cyst
2393:
2344:Vaginal bleeding
2237:
2170:
2146:Uterine prolapse
1974:Menometrorrhagia
1898:
1851:
1842:
1741:Ovarian apoplexy
1685:
1676:
1650:
1643:
1636:
1627:
1620:
1617:
1611:
1610:
1600:
1590:
1566:
1560:
1559:
1541:
1517:
1511:
1510:
1500:
1468:
1462:
1461:
1425:
1414:
1413:
1388:(3): 1140–1146.
1377:
1371:
1370:
1360:
1328:
1319:
1318:
1281:
1272:
1271:
1235:
1224:
1223:
1213:
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1175:
1174:
1138:
1132:
1131:
1129:
1128:
1114:
1108:
1107:
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1065:
1059:
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1048:
1016:
1010:
1009:
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1006:
992:
986:
980:
979:
964:
958:
957:
947:
915:
909:
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898:
888:
864:
819:
818:
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776:
770:
769:
759:
727:
718:
717:
715:
714:
705:
697:
691:
690:
680:
656:
650:
644:
643:
639:
637:
636:
622:
616:
615:
613:
612:
598:
592:
591:
571:
565:
564:
562:
561:
547:
541:
540:
530:
520:
496:
411:. The estimated
369:vaginal estrogen
347:vaginal estrogen
333:Other treatments
298:Vaginal dilators
143:cervical cancers
41:Vaginal stenosis
22:Vaginal stenosis
19:
2534:
2533:
2529:
2528:
2527:
2525:
2524:
2523:
2504:
2503:
2502:
2497:
2496:
2462:
2448:
2439:
2380:
2355:
2335:
2268:
2231:
2226:
2222:Vaginal atresia
2155:
2115:
2074:Cervical cancer
2060:
2042:
2038:Uterine fibroid
2015:
1995:
1979:Polymenorrhagia
1920:Oligoamenorrhea
1892:
1887:
1827:
1782:
1778:Ovarian torsion
1667:
1657:Female diseases
1654:
1624:
1623:
1618:
1614:
1568:
1567:
1563:
1519:
1518:
1514:
1470:
1469:
1465:
1427:
1426:
1417:
1379:
1378:
1374:
1343:(9): CD007291.
1330:
1329:
1322:
1283:
1282:
1275:
1237:
1236:
1227:
1183:
1182:
1178:
1140:
1139:
1135:
1126:
1124:
1116:
1115:
1111:
1080:(2): CD000081.
1067:
1066:
1062:
1018:
1017:
1013:
1004:
1002:
1000:www.eviq.org.au
994:
993:
989:
977:
965:
961:
917:
916:
912:
866:
865:
822:
778:
777:
773:
729:
728:
721:
712:
710:
703:
699:
698:
694:
658:
657:
653:
641:
634:
632:
624:
623:
619:
610:
608:
600:
599:
595:
588:
573:
572:
568:
559:
557:
549:
548:
544:
498:
497:
466:
461:
449:
425:cervical cancer
385:
351:Hyaluronic acid
339:hyaluronic acid
335:
311:quality of life
307:sexual function
294:vaginal dilator
290:
285:
260:
223:
203:cervical cancer
195:
124:
119:
97:
87:in people with
17:
12:
11:
5:
2532:
2530:
2522:
2521:
2519:Women's health
2516:
2506:
2505:
2499:
2498:
2495:
2494:
2479:
2463:
2458:
2457:
2455:
2454:Classification
2445:
2444:
2441:
2440:
2438:
2437:
2432:
2427:
2422:
2417:
2412:
2407:
2401:
2399:
2390:
2386:
2385:
2382:
2381:
2379:
2378:
2373:
2367:
2365:
2361:
2360:
2357:
2356:
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2353:
2352:
2351:
2340:
2337:
2336:
2334:
2333:
2332:
2331:
2326:
2321:
2316:
2311:
2301:
2296:
2295:
2294:
2289:
2284:
2282:Ureterovaginal
2273:
2270:
2269:
2267:
2266:
2261:
2259:Vaginal cancer
2256:
2251:
2246:
2240:
2238:
2228:
2227:
2225:
2224:
2219:
2214:
2213:
2212:
2207:
2202:
2192:
2183:
2173:
2167:
2161:
2160:
2157:
2156:
2154:
2153:
2151:Uterine cancer
2148:
2143:
2138:
2133:
2123:
2121:
2117:
2116:
2114:
2113:
2111:Nabothian cyst
2108:
2107:
2106:
2096:
2091:
2089:Cervical polyp
2086:
2081:
2076:
2070:
2068:
2062:
2061:
2059:
2058:
2052:
2050:
2044:
2043:
2041:
2040:
2035:
2029:
2027:
2021:
2020:
2017:
2016:
2014:
2013:
2012:
2011:
2000:
1997:
1996:
1994:
1993:
1992:
1991:
1983:
1982:
1981:
1976:
1968:
1967:
1966:
1961:
1951:
1950:
1949:
1944:
1934:
1933:
1932:
1927:
1925:Oligomenorrhea
1922:
1917:
1912:
1901:
1899:
1889:
1888:
1886:
1885:
1880:
1875:
1870:
1865:
1860:
1854:
1848:
1839:
1833:
1832:
1829:
1828:
1826:
1825:
1820:
1815:
1810:
1805:
1804:
1803:
1792:
1790:
1788:Fallopian tube
1784:
1783:
1781:
1780:
1775:
1773:Ovarian cancer
1770:
1765:
1764:
1763:
1758:
1753:
1743:
1738:
1733:
1728:
1727:
1726:
1721:
1720:
1719:
1717:Oligoovulation
1714:
1699:
1693:
1691:
1682:
1673:
1669:
1668:
1655:
1653:
1652:
1645:
1638:
1630:
1622:
1621:
1612:
1561:
1512:
1483:(6): 479–491.
1463:
1436:(2): 212–220.
1415:
1372:
1320:
1293:(3): 637–649.
1273:
1246:(3): 493–514.
1225:
1196:(2): 263–273.
1176:
1133:
1109:
1060:
1031:(3): 179–184.
1011:
987:
959:
910:
820:
791:(2): 359–368.
771:
742:(4): 341–352.
719:
692:
651:
617:
593:
586:
580:. F.A. Davis.
566:
542:
463:
462:
460:
457:
456:
455:
448:
445:
397:type of cancer
384:
381:
334:
331:
289:
286:
284:
281:
259:
256:
222:
219:
194:
191:
123:
120:
118:
115:
96:
93:
36:
35:
30:
24:
23:
15:
13:
10:
9:
6:
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3:
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2431:
2428:
2426:
2423:
2421:
2418:
2416:
2413:
2411:
2408:
2406:
2405:Vulvar cancer
2403:
2402:
2400:
2398:
2394:
2391:
2387:
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2372:
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2312:
2310:
2307:
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2302:
2300:
2297:
2293:
2290:
2288:
2287:Vesicovaginal
2285:
2283:
2280:
2279:
2278:
2275:
2274:
2271:
2265:
2262:
2260:
2257:
2255:
2252:
2250:
2247:
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2242:
2241:
2239:
2236:
2235:
2229:
2223:
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2211:
2208:
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2203:
2201:
2198:
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2191:
2187:
2184:
2182:
2178:
2175:
2174:
2171:
2168:
2166:
2162:
2152:
2149:
2147:
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2142:
2139:
2137:
2134:
2132:
2128:
2125:
2124:
2122:
2118:
2112:
2109:
2105:
2102:
2101:
2100:
2097:
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2092:
2090:
2087:
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2077:
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2057:
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2036:
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2031:
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2026:
2022:
2010:
2007:
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2002:
2001:
1998:
1990:
1987:
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1984:
1980:
1977:
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1972:
1971:
1969:
1965:
1962:
1960:
1957:
1956:
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1952:
1948:
1945:
1943:
1940:
1939:
1938:
1935:
1931:
1928:
1926:
1923:
1921:
1918:
1916:
1915:Hypomenorrhea
1913:
1911:
1908:
1907:
1906:
1903:
1902:
1900:
1897:
1896:
1890:
1884:
1881:
1879:
1878:Endometriosis
1876:
1874:
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1869:
1866:
1864:
1861:
1859:
1856:
1855:
1852:
1849:
1847:
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1824:
1821:
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1816:
1814:
1813:Hematosalpinx
1811:
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1731:Mittelschmerz
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1212:
1207:
1203:
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1177:
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984:
983:public domain
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946:
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937:
933:
930:(1): 95–108.
929:
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924:Brachytherapy
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647:public domain
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405:brachytherapy
402:
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387:The reported
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363:
359:
358:Laser therapy
355:
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348:
344:
343:laser therapy
341:application,
340:
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238:who have had
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155:brachytherapy
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62:
58:
54:
50:
46:
42:
34:
31:
29:
25:
20:
2481:
2466:
2324:Sigmoidocele
2232:
2177:Hematocolpos
2056:Parametritis
1964:Metrorrhagia
1942:Dysmenorrhea
1895:Menstruation
1893:
1883:Endometritis
1818:Hydrosalpinx
1746:Ovarian cyst
1615:
1578:
1574:
1564:
1532:(1): 49–55.
1529:
1525:
1515:
1480:
1476:
1466:
1433:
1429:
1385:
1381:
1375:
1340:
1336:
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1239:
1193:
1189:
1179:
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1142:
1136:
1125:. Retrieved
1121:
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1073:
1063:
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1024:
1014:
1003:. Retrieved
999:
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711:. Retrieved
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633:. Retrieved
629:
620:
609:. Retrieved
605:
596:
576:
569:
558:. Retrieved
554:
545:
508:
504:
393:radiotherapy
386:
383:Epidemiology
373:radiotherapy
366:
356:
336:
327:
315:
291:
277:
261:
252:vaginoplasty
227:Episiotomies
224:
196:
193:Risk factors
125:
111:
105:
98:
81:Chemotherapy
40:
39:
2329:Urethrocele
2244:Dyspareunia
2217:Hydrocolpos
2181:Hydrocolpos
2127:Hematometra
2048:Parametrium
2033:Adenomyosis
1846:Endometrium
1823:Salpingitis
1712:Anovulation
1581:(6): 1639.
969:NCT03090217
511:: 273–279.
437:anal cancer
244:adolescence
211:Tobacco use
65:pelvic exam
53:dyspareunia
2508:Categories
2477:1126562070
2430:Vulvodynia
2314:Enterocele
2264:Vaginismus
2186:Leukorrhea
2094:Cervicitis
2025:Myometrium
1910:Amenorrhea
1736:Oophoritis
1127:2022-08-01
1005:2018-03-11
879:(4): 336.
713:2022-03-14
635:2018-03-14
611:2018-03-11
560:2018-03-11
459:References
319:epithelial
272:strictures
250:, such as
231:episiotomy
163:epithelium
153:(EBRT) or
77:episiotomy
33:Gynecology
2319:Rectocele
2309:Cystocele
2195:Vaginitis
1458:211026055
1315:233355491
1268:231766638
687:0104-0707
429:incidence
413:incidence
389:incidence
303:adherence
283:Treatment
258:Diagnosis
183:adhesions
28:Specialty
2425:Vulvitis
2389:External
2304:Prolapse
2131:Pyometra
1672:Internal
1665:genitals
1607:32575821
1556:30214069
1507:31302301
1450:32014450
1410:12423507
1402:16803497
1367:25198150
1307:33891152
1260:33526400
1220:32840336
1171:45876518
1163:26995108
1104:28176333
1055:25925294
954:27260082
905:33915994
873:Medicina
815:26556768
766:24622419
537:28496367
447:See also
323:fibrosis
175:fibrosis
2120:General
1659:of the
1598:7352893
1575:Cancers
1548:9260566
1498:7944435
1358:6513398
1211:7857744
1095:5449575
1046:4510333
945:5612425
896:8066324
806:4835814
757:4163910
528:5422455
171:hypoxia
167:atrophy
131:vaginal
127:Uterine
107:Atrophy
71:to the
2165:Vagina
2066:Cervix
1985:Other
1970:Mixed
1954:Timing
1837:Uterus
1680:Adnexa
1661:pelvis
1605:
1595:
1554:
1546:
1505:
1495:
1456:
1448:
1408:
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708:Uhn.ca
685:
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535:
525:
427:. The
345:, and
215:pallor
179:Pallor
173:, and
139:rectal
117:Causes
73:pelvis
45:vagina
2492:N89.5
2397:Vulva
2364:Other
1689:Ovary
1552:S2CID
1454:S2CID
1406:S2CID
1311:S2CID
1264:S2CID
1167:S2CID
704:(PDF)
671:(2).
377:tumor
75:, an
63:or a
1937:Pain
1905:Flow
1663:and
1603:PMID
1544:PMID
1503:PMID
1446:PMID
1398:PMID
1363:PMID
1341:2014
1303:PMID
1256:PMID
1216:PMID
1159:PMID
1100:PMID
1078:2017
1051:PMID
950:PMID
901:PMID
811:PMID
762:PMID
683:ISSN
582:ISBN
533:PMID
435:for
401:EBRT
309:and
141:and
135:anal
2483:ICD
2468:ICD
1593:PMC
1583:doi
1534:doi
1530:242
1493:PMC
1485:doi
1438:doi
1390:doi
1353:PMC
1345:doi
1295:doi
1248:doi
1206:PMC
1198:doi
1151:doi
1147:165
1090:PMC
1082:doi
1041:PMC
1033:doi
940:PMC
932:doi
891:PMC
881:doi
801:PMC
793:doi
789:140
752:PMC
744:doi
673:doi
523:PMC
513:doi
439:or
403:or
391:of
266:'s
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2475::
2472:11
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1418:^
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187:RT
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