Pilot study of vaginal plethysmography in women treated with radiotherapy for gynecological cancer

Objectives. After pelvic radiotherapy for gynecological cancer, changes in the vaginal epithelium might influence sexual arousal and satisfaction, leading to dyspareunia and relational problems. The aim of the study was to determine the feasibility of vaginal plethysmography in order to measure physical late effects of this therapy on sexual function.

Methods. Patients treated with radiotherapy for cervical, endometrial, or ovarian cancer, who were in complete remission for over I year, underwent vaginal plethysmography to measure changes in vaginal vasocongestion, while watching erotic video fragments. Afterward two questionnaires, designed to measure feelings of sexual arousal during the video, and to identify sexual dysfunction, were completed. The results were compared with those of healthy women.

Results. Patients (n = 9) and volunteers (n = 8) did not differ in baseline amplitude of plethysmography and showed comparable changes in vaginal vasocongestion during the various video fragments. The decline in amplitude during the last video fragment in the patient group did not reach significance, but the group of patients is small and heterogeneous. Addressing subjective sexual arousal during the video, patients reported less feelings of lust and desire and fewer bodily sensations while watching than the controls. Patients worried more about the sexual satisfaction of their partners than controls.

Conclusion. Vaginal plethysmography can be used to measure vaginal vasocongestion in patients treated with radiotherapy to the proximal vagina. In this pilot study the changes of vaginal vasocongestion during sexual arousal between patients and healthy volunteers were not different. This correlates with a comparable sexual satisfaction, although patients reported less feelings of lust. (C) 2003 Elsevier Inc. All rights reserved.