- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07473271
Vaginal Function Exercisers and Vaginal Dilation Irrigation Drug Administration Tubes Are Used for Vaginal Rehabilitation Therapy in Pelvic Radiotherapy (Exerciser)
A Prospective, Multicenter, Single-Arm Clinical Trial to Evaluate the Safety and Efficacy of Vaginal Function Exercisers and Vaginal Dilation Irrigation Drug Delivery Tubes for Vaginal Rehabilitation in Patients Undergoing Pelvic Radiotherapy
Gynecological pelvic tumors primarily include ovarian cancer, cervical cancer, and endometrial cancer. Radiotherapy (RT) is one of the key treatment modalities for gynecological tumors. It is a necessary therapeutic approach for 80% to 90% of cervical cancer patients and 60% of endometrial cancer patients . The vagina, as a target organ and critical vulnerable organ for RT, may be affected by radiation, leading to adverse effects such as vaginal mucosal changes, adhesions, stenosis, or atresia . Vaginal stenosis (VS) is a common yet often overlooked side effect in female patients undergoing pelvic tumor RT, frequently causing symptoms such as dyspareunia, pain, vaginal dryness, or vaginal bleeding . Brand AH et al. prospectively recorded VS data from 179 cervical cancer patients receiving RT, with an average follow-up of 9.6 months, and found that 38% of patients developed VS. Park HS et al. documented VS data from endometrial cancer patients undergoing intravaginal brachytherapy, with an average follow-up of 12.9 months, and reported a VS incidence of 33%. Thais de Morais Siqueira et al. recorded subsequent VS in patients who underwent pelvic RT, with VS prevalence rates of 79% in cervical cancer patients and 67% in endometrial cancer patients. The occurrence of vaginal stenosis can impair patients' later sexual quality of life and comfort satisfaction, which is a crucial factor affecting marital relationship . Failure to prevent or address vaginal stenosis promptly may lead to psychological issues such as anxiety and depression in patients, while both physical and psychological distress can result in a decline in overall quality of life . When progressing to severe vaginal stenosis or vaginal atresia, it not only increases the discomfort during gynecological examinations but also reduces the probability of early detection of tumor recurrence, thereby affecting long-term patient survival .
Current research in China regarding the contributing factors and preventive measures for vaginal stenosis remains in the exploratory phase, with insufficient attention paid to this condition. Current clinical practice predominantly emphasizes the preventive role of vaginal irrigation against infections . During vaginal irrigation, dilators are only briefly used as a substitute for dilation. For cervical cancer patients undergoing radical radiotherapy, routine vaginal irrigation is performed both during and after the treatment. Post-radiotherapy, patients are advised to undergo routine vaginal dilation therapy.
The most commonly used method for preventing vaginal stenosis is the application of vaginal dilators or related molds. Bakker et al. demonstrated that regular use of finger dilation, vaginal dilators, or other types of dilators can improve female patients' sexual function and gradually restore normal vaginal size. Law et al. confirmed that persistent use of vaginal dilators for 6 months significantly restored vaginal size to pre-radiotherapy levels. A study investigating the use of vaginal dilators in patients undergoing pelvic tumor radiotherapy found that 80.0% of patients did not develop vaginal stenosis at 12 months post-radiotherapy, demonstrating that consistent use of vaginal dilators effectively reduces the severity of vaginal stenosis . Martins J et al. conducted a trial comparing local estrogen, local testosterone, placebo, and vaginal dilators for the prevention of vaginal stenosis (VS) in women undergoing radiotherapy for cervical cancer. After 12 months of follow-up, among 142 patients, the prevalence of VS was 11% in those treated with vaginal dilators, 57% in placebo users, and 56.8% in estrogen-treated women, confirming the efficacy of vaginal dilators in reducing VS incidence. Stahl JM et al. enrolled 243 patients who received high-dose brachytherapy (HDR) in the vagina, all of whom were treated with vaginal dilators. At 12 months, the rate of no VS occurrence was 63.5% in non-adherent patients, 70.2% in standard-adherent patients, and 81.2% in extended-adherence patients, further validating the effectiveness of persistent vaginal dilator use in reducing vaginal stenosis. Jiang Song et al. retrospectively analyzed 80 cervical cancer patients who underwent radical radiotherapy at Xuzhou Cancer Hospital from January 2017 to December 2018. The patients were divided into two groups: the control group (40 cases) received only vaginal irrigation, while the observation group (40 cases) received vaginal irrigation combined with vaginal mold application. The incidence of vaginal stenosis was compared between the two groups at 3 months post-radiotherapy. Results: The vaginal stenosis rate in the observation group was 32.50%, while that in the control group was 70.00%, with a statistically significant difference (P <0.05). The use of vaginal mold was associated with a reduced incidence of radiation-induced vaginal stenosis in cervical cancer patients.
Study Overview
Status
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Beijing Municipality
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Beijing, Beijing Municipality, China, 100730
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- women aged 18 to 70 years.
- After radiotherapy for pelvic tumors, the tumor is well controlled (no macroscopically visible tumor). At least 1 week after radiotherapy, regular vaginal dilation and irrigation are expected to be performed subsequently.
- ECOG 0-2.
- prospected survival greater than 6 months.
- Good communication skills, no history of mental illness.
- Consent to participate in this trial and voluntarily sign the informed consent form.
Exclusion Criteria:
- Malignant tumors in other parts of the body.
- congenital vaginal stenosis or pre-enrollment confirmed vaginal stenosis.
- Allergic to silica gel and polyvinyl chloride materials.
- active vaginal bleeding.
- It is anticipated that cooperation with the treatment will not be possible.
- The disease may cause difficulties in treatment and evaluation (e.g., sepsis, inability of the patient to tolerate treatment, etc.).
- pregnant and lactating women.
- Participated in other clinical trials involving drugs or medical devices within the past 3 months.
- The investigators consider other conditions unsuitable for participation in this trial.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Test Group
|
It is recommended to perform the procedure 2-3 times per week, with appropriate adjustments under the guidance of the investigator.
In principle, it should not exceed once every other day.
Each dilation session should last 10-20 minutes.
For irrigation, it is suggested to use normal saline or warm water, with an irrigation volume of approximately 100-200 mL, and the procedure should be continued for 6 months.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Incidence of vaginal stenosis at 6 months after enrollment
Time Frame: six months
|
six months
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- KS20251711
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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