Risks of rigid dilation for a radiated vaginal cuff: two related rectovaginal fistulas.

BACKGROUND: Dyspareunia secondary to significant radiation fibrosis of the vagina is a difficult clinical problem. The benefit of vaginal dilator therapy in such patients is unclear. CASE: We report two patients who had attempted dilation and elongation of a small, fibrotic, heavily radiated vagina and subsequently developed a rectovaginal fistula.
CONCLUSION: Use of a rigid dilator in an attempt to lengthen a heavily radiated vaginal cuff may be hazardous.