Vaginal stenosis

Vaginal stenosis is an abnormal condition in which the vagina becomes narrower and shorter due to the formation of fibrous tissue.

[1][2] Vaginal stenosis can contribute to sexual dysfunction, dyspareunia and make pelvic exams difficult and painful.

[1] Symptoms can worsen from post treatment ovarian failure or menopausal status, leading to reduced lubrication and increased thinning of the vaginal tissue.

Damage to the vaginal epithelium causes abnormal collagen production that leads to atrophy, loss of muscle, decreased blood flow, hypoxia, and fibrosis.

[15] When the tissue from the episiotomy does not heal properly, complications can include mucosal damage and scarring,[16] which can contribute to the development of vaginal stenosis.

Vaginal stenosis is the most common post-operative complication in people with congenital adrenal hyperplasia who have had genital reconstructive surgery in infancy or childhood.

[8] Additionally, in people undergoing a male-to female gender-affirming surgical procedure, such as vaginoplasty, vaginal stenosis has been shown to be a common post-surgical complication.

[10] The LENT-SOMA grading scale for vaginal stenosis is based on the assessment of subjective symptoms, analytical tests, and observed clinical manifestations.

[1] 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.

[23] Vaginal dilator therapy requires a consistent routine and may cause physical and/or psychological discomfort, which makes adherence to treatment difficult.

[19] It may be difficult to evaluate the efficacy of vaginal dilation therapy as measures of sexual function and quality of life are hard to quantify and control for.

[21] Optimal duration of vaginal dilator therapy and its improvements on sexual function and cancer-related outcomes remain unclear.

[10] 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.