HDR Vaginal Cuff

HDR (High Dose Rate Radiation)

This refers to the use of radiation tubes that produce radiation at a fast rate so that the treatment can be completed in minutes (rather than the hours it used to take with radium or cesium tubes.) The radiation is Iridium 192 and the machine is called a Gamma Med HDR device.

The treatments are performed in the cancer center at St. Anthony’s and the patient is generally in and out of the department in 15 to 20 minutes. The tube is inserted into the vagina and held in place by a connector attached to the table. The tube is hollow and a radioactive wire slides in and out of the tube during the treatment but never touches the patient. There is no sensation, pain or discomfort during the treatments.

The radiation does not penetrate very deeply and is primarily confined to the wall of the vagina, so the amount that reaches the rectum or bladder is small. Some women may notice slight bladder irritation (stinging or frequency) that shows up a few days after each treatment. A few women may also get some rectal irritation (burning, gas or diarrhea) that may also show up. There may also be slight vaginal irritation or drainage after the treatments.

The risk of long term complications with vaginal vault HDR is quite low. Theoretically a slight risk of a radiation burn to the bladder or rectum. The lining of the vagina is more likely to show a reaction with some dryness or narrowing of the vault. Some women may benefit from using vaginal dilators or lubricants after having these treatments.