How do you counsel a cervical cancer patient s/p definitive chemoRT who is not sexually active and refuses to use vaginal dilators to improve compliance?  

There isn't much you can do except talk with them about the reasons for non-compliance (has it been painful, embarrassing, discuss rationale and encourage them. Are they unsure how to use it?- having them insert it during their clinic exam may help. If the dilator is causing pain, lubricants or vag...

An option is to follow the patient more closely than you might otherwise, probably monthly. Usually, thin adhesions begin to form that can easily be bluntly separated by the examining finger prior to inserting the speculum. Doing this at least monthly can usually prevent or at least forestall the mo...