Vaginal radiotherapy

It is indicated in mucosal candidiasis, systemic candidiasis, crypttococcosis, prophylaxis of fungal infections following cytotoxic chemotherapy or radiotherapy maintenance to prevent relapse of cryptococcal meningitis in patients with AIDS sporotrichosis, histoplasmosis and vaginal candidiasis. 

Edematous and inflammatory reactions of the vagina that persist for up to about 6 months after radiotherapy are associated with an increased signal intensity of the vaginal wall on T2-weighted images. The observed increase in signal intensity is directly proportion to the total radiation dose administered and always occurs above a threshold dose of 45 Gy. The mode of admin-... 

Fig. 12.22a,b. Vaginal stenosis. T2-weighted images in axial and sagittal orientation. Vaginal stenosis in the proximal third of the vagina after radiotherapy. There is hematometra (a) and hematosalpinx (b) short arrows). (Reproduced with permission from [13])... 

Recurrent tumors after surgery are seen as a soft tissue mass in the region of the vaginal vault, usually with involvement of the adjacent parametrium. After radiotherapy, the tumor is seen as a mass within the cervix. The involvement of the pelvic floor or the sidewalls is essential for planning resection of primary and recurrent tumors. 

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