Management of radionecrosis of the vulva and distal vagina

Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and...

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Published inAmerican journal of obstetrics and gynecology Vol. 164; no. 5 Pt 1; p. 1235
Main Authors Roberts, W S, Hoffman, M S, LaPolla, J P, Ruas, E, Fiorica, J V, Cavanagh, D
Format Journal Article
LanguageEnglish
Published United States 01.05.1991
Subjects
Adult
Aged
Aged, 80 and over
Female
Humans
Middle Aged
Necrosis - diagnostic imaging
Radiation Injuries - drug therapy
Radiation Injuries - surgery
Radionuclide Imaging
Retrospective Studies
Vagina - pathology
Vagina - surgery
Vulva - pathology
Vulva - surgery
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Summary:Twelve patients were seen between January 1983 and June 1989 with the clinical diagnosis of radionecrosis of the vulva or distal vagina. Seven patients received radiation for vulvar cancer, three for distal vaginal cancer, and two for recurrent endometrial cancer. No patient healed spontaneously and the mean delay in surgical therapy was 8.5 months. The radionecrotic site was treated with local therapy, radical local excision (with or without colostomy), or exenteration. The operative defect was closed primarily in three patients and covered with local flaps or myocutaneous flaps in seven patients. The two patients with local care still have radionecrotic ulcers. One of three patients who were closed primarily continues to have an ulcer. All other patients have healed satisfactorily except one who died after two attempts to correct the problem. Radionecrosis of the vulva and distal vagina should generally be treated surgically.
ISSN:0002-9378
DOI:10.1016/0002-9378(91)90690-S