Practice Variability in Prescribing Vaginal Dilators After Brachytherapy for Gynaecological Cancer

2.50
Hdl Handle:
http://hdl.handle.net/10755/165542
Category:
Abstract
Type:
Presentation
Title:
Practice Variability in Prescribing Vaginal Dilators After Brachytherapy for Gynaecological Cancer
Author(s):
Lancaster, Letitia
Author Details:
Letitia Lancaster, Westmead Hospital, Westmead, Sydney, Australia
Abstract:
Despite advances in brachytherapy techniques, patients still experience a variety of complications from treatment. While it is important to address those that are life threatening, it is equally important to acknowledge those that affect quality of life. Vaginal stenosis is a common toxicity of brachytherapy for the treatment of gynaecological cancer, with a reported incidence of up to 80%. It can result in long term sexual dysfunction and painful vaginal examinations, but may be prevented by regular sexual intercourse or the use of vaginal dilators. An assessment of the information provided to patients at Westmead Hospital (Sydney, Australia) about the use of dilators revealed inconsistencies among staff and practice based on tradition and personal preference, rather than evidence. A review of the nursing and medical literature revealed that vaginal stenosis is infrequently reported with the same rigour as bowel and bladder toxicities, and preventative strategies are rarely described. In an attempt to achieve consensus, a telephone survey of 16 other cancer centres administering vaginal brachytherapy in Australia was undertaken to ascertain their practices in preventing vaginal stenosis. The findings revealed a lack of consistency between all variables for all centres. Patients who are advised to use dilators ranged from none to all, time to initiate use ranged from prior to brachytherapy to six weeks after completion of brachytherapy, frequency of use ranged from three times a day to once a week, insertion time ranged from two to 20 minutes, and duration of use ranged from six weeks to indefinitely. Most centres provided dilators in a range of sizes, however only three centres provided written information. We have therefore developed unit guidelines for the management of all patients at risk of developing vaginal stenosis and a patient information brochure on the use of vaginal dilators, both underpinned by the limited information gleaned from the literature. Future research priorities will consider the formal evaluation of patient compliance and the efficacy of vaginal dilators in the prevention of vaginal stenosis.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
27th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePractice Variability in Prescribing Vaginal Dilators After Brachytherapy for Gynaecological Canceren_GB
dc.contributor.authorLancaster, Letitiaen_US
dc.author.detailsLetitia Lancaster, Westmead Hospital, Westmead, Sydney, Australiaen_US
dc.identifier.urihttp://hdl.handle.net/10755/165542-
dc.description.abstractDespite advances in brachytherapy techniques, patients still experience a variety of complications from treatment. While it is important to address those that are life threatening, it is equally important to acknowledge those that affect quality of life. Vaginal stenosis is a common toxicity of brachytherapy for the treatment of gynaecological cancer, with a reported incidence of up to 80%. It can result in long term sexual dysfunction and painful vaginal examinations, but may be prevented by regular sexual intercourse or the use of vaginal dilators. An assessment of the information provided to patients at Westmead Hospital (Sydney, Australia) about the use of dilators revealed inconsistencies among staff and practice based on tradition and personal preference, rather than evidence. A review of the nursing and medical literature revealed that vaginal stenosis is infrequently reported with the same rigour as bowel and bladder toxicities, and preventative strategies are rarely described. In an attempt to achieve consensus, a telephone survey of 16 other cancer centres administering vaginal brachytherapy in Australia was undertaken to ascertain their practices in preventing vaginal stenosis. The findings revealed a lack of consistency between all variables for all centres. Patients who are advised to use dilators ranged from none to all, time to initiate use ranged from prior to brachytherapy to six weeks after completion of brachytherapy, frequency of use ranged from three times a day to once a week, insertion time ranged from two to 20 minutes, and duration of use ranged from six weeks to indefinitely. Most centres provided dilators in a range of sizes, however only three centres provided written information. We have therefore developed unit guidelines for the management of all patients at risk of developing vaginal stenosis and a patient information brochure on the use of vaginal dilators, both underpinned by the limited information gleaned from the literature. Future research priorities will consider the formal evaluation of patient compliance and the efficacy of vaginal dilators in the prevention of vaginal stenosis.en_GB
dc.date.available2011-10-27T12:20:32Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:20:32Z-
dc.conference.date2002en_US
dc.conference.name27th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationWashington, D.C., USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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