• Reference Number: HEY-038/2019
• Departments: Gynaecology, Radiotherapy
• Last Updated: 31 July 2019

Introduction

This leaflet has been produced to give you general information about your treatment. Most of your questions should have been answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

Why do I need to use Vaginal Dilators?

Brachytherapy may cause scarring and narrowing of the vagina, therefore pelvic care after treatment is recommended, which aims to reduce these problems. This can be done by the use of vaginal dilators and pelvic floor exercises.

What does the dilator do?

The purpose of the dilator is to stretch and dilate (keep open) the vaginal walls making routine internal examination easier at your follow-up appointments. The other benefit of this is to make sexual intercourse more comfortable now and in the future.

When will I be given the dilators?

The dilators will be provided by a brachytherapy radiographer and they will explain how to assemble and when to use them. The dilator kit has four hollow tubes ranging in size; lubrication gel sachets will also be provided.

How do I use the dilators?

You will need to use the dilators after your first follow up appointment this will be approximately six weeks after your treatment is complete. The dilators should be used for five minutes, three times a week.

Step by step guide

• Wash the dilators with hot soapy water ensuring all traces of soap have been washed away
• Assemble the dilator
• Lubricate the tip of the dilator and vaginal opening using the lubrication gel provided
• Find a comfortable relaxing position similar to inserting a tampon for example lying on your back with your knees bent
• Insert the dilator into the vagina as far as is comfortable for you; do not force the dilator
• Once comfortable rotate the dilator in a circular motion for five minutes
• As you remove the dilator move it side to side
• Clean the dilator with warm soapy water and dry

When using the dilators or having intercourse you may experience some discomfort. If it is too uncomfortable try using the dilators a few days later. You may also experience some spotting/bleeding, which is normal.  If the bleeding persists, is unduly heavy or you cannot insert the dilator, then you can contact the brachytherapy radiographers or your Gynaecology Nurse Specialist for further advice.

How will this affect my sex life?

If you are sexually active, then maintaining this during and after radiotherapy can be difficult for both you and your partner.  It may be that you have become sore during treatment or just that other things are more important to you at this time.  If possible, talk to your partner about this and share your feelings so you can work through it together.  It might be easier for you to try a more comfortable sexual position or to use a water soluble lubricant.

Once your normal sex life resumes, you can combine the use of dilators and intercourse ensuring that the vagina is dilated three times a week.  The guidelines recommend that you continue with this for the foreseeable future or until advised otherwise by doctor.

Contact Numbers

If you need to speak to a member of staff regarding your appointments, please ring the Radiotherapy Booking Office. Any other queries regarding your brachytherapy, please contact a member of the brachytherapy team via Radiotherapy Reception or the Brachytherapy Suite.

Radiotherapy Booking Office        (01482) 461187 / 461188 / 461189

Radiotherapy Reception                (01482) 461191

Brachytherapy Suite                       (01482) 461950 / 461951

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Information & Support Team on telephone number: (01482) 461206 or e-mail: hyp-tr.radiotherapy.information@nhs.net

Please find below the contact details of useful organisations that provide information about cancer including radiotherapy treatments:

Macmillan Cancer Support

Provide information from specialist nurses on all aspects of cancer and its treatment, and on the practical and emotional aspects of living with cancer.

Free phone help line: 0808 808 00 00 (7 days a week, 8am-8pm)

Online: www.macmillan.org.uk

Write to: 3 Bath Place, Rivington Street, London, EC2A 3JR

PALS (Patient Advice and Liaison Service)

Provide confidential advice and support, helping you to sort out any concerns you may have about the care we provide, guiding you through the different services available from the NHS.

Telephone: (01482) 623065 (Monday – Friday 9:00am – 4:00pm)

Email: hyp-tr.pals.mailbox@nhs.net

Macmillan Sexuality Counsellor

For queries or to arrange an appointment please contact Oncology Health Centre, Queen’s Centre, Castle Hill Hospital, Cottingham, HU16 5JQ.

Telephone: (01482) 461232 / 461060

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.