From "Sex Toy" to Intrusive Imposition: A Qualitative Examination of Women's Experiences with Vaginal Dilator Use Following Treatment for Gynecological Cancer

Journal of Sexual Medicine

Volumn 9, Issue 4, 2012, Pages 1162-1173

  Cullen, Kimberley ^a   Fergus, Karen ^a,b   Dasgupta, Tracey ^c   Fitch, Marg ^b,c   Doyle, Catherine ^b   Adams, Lauran ^b  

^a YORK UNIVERSITY   (Canada)

^b DEPARTMENT OF RADIATION ONCOLOGY   (Canada)

^c SUNNYBROOK RESEARCH INSTITUTE   (Canada)

Author keywords

Gynecological cancer; Qualitative research; Radiotherapy; Treatment adherence; Vaginal dilators; Vaginal health promotion

Indexed keywords

ADULT; AGED; ANXIETY; ARTICLE; CLINICAL ARTICLE; COPING BEHAVIOR; EXPECTATION; FEMALE; GYNECOLOGIC CANCER; HUMAN; OPEN ENDED QUESTIONNAIRE; OUTCOME ASSESSMENT; PAIN; PERSONAL EXPERIENCE; PRIORITY JOURNAL; PROSTHESES AND ORTHOSES; QUALITATIVE ANALYSIS; SEXUALITY; SOCIAL PSYCHOLOGY; VAGINA DILATOR;

EID: 84859270600     PISSN: 17436095     EISSN: 17436109     Source Type: Journal    
DOI: 10.1111/j.1743-6109.2011.02639.x     Document Type: Article

References (32)

1. American Cancer Society (ACS). Global cancer facts and figures. 2007. Available at: (accessed July 5, 2011).
2. Canadian Cancer Society (CCS). Canadian cancer statistics. 2011. Available at: (accessed March 23, 2011).
3. Faithfull S, White I. Delivering sensitive health care information: Challenging the taboo of women's sexual health after pelvic radiotherapy. Patient Educ Couns 2008;71:228-33.
4. Jeffries SA, Robinson JW, Craighead PS, Keats MR. An effective group psychoeducational intervention for improving compliance with vaginal dilation: A randomized controlled trial. Int J Radiat Oncol Biol Phys 2006;65:404-11.
5. Brand AH, Bull CA, Cakir B. Vaginal stenosis in patients treated with radiotherapy for carcinoma of the cervix. Int J Gynecol Cancer 2006;16:288-93.
6. Decruze SB, Guthrie D, Magnani R. Prevention of vaginal stenosis in patients following vaginal brachytherapy. Clin Oncol 1999;11:46-8.
7. Lancaster L. Preventing vaginal stenosis after brachytherapy for gynaecological cancer: An overview of Australian practices. Eur J Oncol Nurs 2004;8:30-9.
8. Friedman LC, Abdallah R, Schluchter M, Panneerselvam A, Kunos CA. Adherence to vaginal dilation following high dose rate brachytherapy for endometrial cancer. Int J Radiat Oncol Biol Phys 2011;80:751-7.
9. Carter J, Sonoda Y, Chi DS, Raviv L, Abu-Rustum NR. Radical trachelectomy for cervical cancer: Postoperative physical and emotional adjustment concerns. Gynecol Oncol 2008;111:151-7.
10. Carter J, Goldrank D, Schover LR. Simple strategies for vaginal health promotion in cancer survivors. J Sex Med 2011;8:549-59.
11. Jefferies H, Hoy S, McCahill R, Crichton A. Guidelines on vaginal dilator use after pelvic radiotherapy. Nurs Times 2007;103:28-9.
12. Johnson N, Miles T, Cornes P. Dilating the vagina to prevent damage from radiotherapy: Systematic review of the literature. BJOG 2010;117:522-31.
13. American Cancer Society (ACS). Preventing pain during sex. 2011. Available at: (accessed June 1, 2011).
14. Denton AS, Maher J. Interventions for the physical aspects of sexual dysfunction in women following pelvic radiotherapy. Cochrane Database Syst Rev 2003;(1):CD003750.
15. Miles T, Johnson N. Vaginal dilator therapy for women receiving pelvic radiotherapy. Cochrane Database Syst Rev 2010;(9):CD007291.
16. Velaskar SM, Martha R, Mahantashetty U, Badakare JS, Shrivastava SK. Use of indigenous vaginal dilator in radiation induced vaginal stenosis. Indian J Occup Ther 2007;34:3-6.
17. White I, Faithfull S. Vaginal dilation associated with pelvic radiotherapy: A UK survey of current practice. Int J Gynecol Cancer 2006;16:1140-6.
18. Schover LR, Fife M, David M, Gershenson DM. Sexual dysfunction and treatment for early stage cervical cancer. Cancer 1989;63:204-12.
19. Bruner DW, Lanciano R, Keegan M, Corn B, Martin E, Hanks GE. Vaginal stenosis and sexual function following intracavitary radiation for the treatment of cervical and endometrial cancer. Int J Radiat Oncol Biol Phys 1993;27:825-30.
20. Punt L. Patient compliance with the use of vaginal dilators following pelvic radiotherapy for a gynecological cancer. J Radiother Pract 2011;10:13-25.
21. Robinson JW, Faris PD, Scott CB. Psychoeducational group increases vaginal dilation for younger women and reduces sexual fears for women of all ages with gynecological carcinoma treated with radiotherapy. Int J Radiat Oncol Biol Phys 1999;44:497-506.
22. White ID. The assessment and management of sexual difficulties after treatment of cervical and endometrial malignancies. Clin Oncol 2008;20:488-96.
23. Juraskov I, Butow P, Robertson L, Sharpe L, McLeod C, Hacker N. Post-treatment sexual adjustment following cervical and endometrial cancer: A qualitative insight. Psychooncology 2003;12:267-79.
24. Glaser BG, Strauss A. The discovery of grounded theory. Strategies for qualitative research. Chicago: Aldine; 1967.
25. Rennie DL, Phillips JR, Quartaro GK. Grounded theory: A promising approach to conceptualization in psychology? Can Psychol 1988;29:139-50.
26. Marcus BS. Changes in a woman's sexual experience and expectations following the introduction of electric vibrator assistance. J Sex Med 2011;8:3398-406.
27. Boeschena LE, Kossa MP, Figueredo AJ, Coan JA. Experiential avoidance and post-traumatic stress disorder. J Aggress Maltreat Trauma 2001;4:211-45.
28. Pineles SL, Mostoufi SM, Ready CB, Street AE, Griffin MG, Resick PA. Trauma reactivity, avoidant coping, and PTSD symptoms: A moderating relationship? J Abnorm Psychol 2011;120:240-6.
29. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process 1991;50:179-211.
30. Blanchard C. Understanding exercise behaviour during home-based cardiac rehabilitation: A theory of planned behaviour perspective. Can J Physiol Pharmacol 2008;86:8-15.
31. Russell KL, Bray SR. Self-determined motivation predicts independent, home-based exercise following cardiac rehabilitation. Rehabil Psychol 2009;54:150-6.
32. Russell KL, Bray SR. Promoting self-determined motivation for exercise in cardiac rehabilitation: The role of autonomy support. Rehabil Psychol 2010;55:74-80.