| Abstract [eng] |
Vaginal stenosis is a narrowing and shortening of the vagina, which can occur after cervical cancer treatment with radiotherapy. Hyaluronic acid injections and intravaginal CO₂ laser are the latest treatments used to restore vaginal function. This study presents a clinical case of a woman with vaginal stenosis, which developed due to cervical cancer treatment, which was treated with hyaluronic acid injections and CO₂ laser. 40 year-old woman was diagnosed with highly differentiated stage IB1 mucinous adenocarcinoma of the cervix. Patient was treated with radical C1 type hysterectomy with lymphonodectomy, and transposition of the ovaries was performed, which was followed by intensity modulated radiotherapy, chemotherapy and brachytherapy. After one year of finishing treatment for cervical cancer the patient was diagnosed with vaginal stenosis which was treated for 5 years with a total of 7 intramucosal hyaluronic acid injections and 5 intravaginal CO₂ laser treatments. Patient filled out the European Organisation for Research and Treatment of Cancer (EORTC) questionnaire module for cervical cancer (QLQ-CX24), which is used for cervical cancer survivors, in which the patient evaluated her state before receiving treatment with hyaluronic acid injections and CO₂ laser and after receiving it. The combined treatment reduced negative symptoms and restored the possibility of intercourse with penetration, although the sexual function was not fully restored. The treatment had no effect for psychological problems related to low sexual function. A review of the scientific literature found that hyaluronic acid injections and intravaginal CO₂ laser are effective methods to improve vaginal and sexual function. It was also noted that more studies are needed with cervical cancer survivors to assess the effect of hyaluronic acid injections, to determine the most appropriate number of CO₂ laser treatments and to evaluate the effect of combined treatment. |
