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Vulvar rinsing for vulvar cancer


Medical editor Gunnar B. Kristensen MD
Gynecological Oncologist
Oslo University Hospital

General

Vulvar rinsing is a procedure performed by request of a gynecologist. It is used to relieve soreness and discharge associated with external radiation therapy, or routinely after a bowel movement on a vulvectomee.

Indications

  • Patients with advanced cancer with necrosis, tumor mass, or vaginal discharge. 
  • Patients receiving external radiation therapy to the vulva where there is soreness or soreness may occur. 
  • Patients susceptible to infection or having confirmed infection in the vulva.
  • Patients who otherwise could use a hand-held shower head, but who are not capable of self-care. 
  • After a bowel movement on a vulvectomee. 
  • Any other indication where gynecologist recommends vulvar rinsing. 

Goal

  • Prevent soreness and infections.
  • Keep tumor masses and sore surfaces as clean as possible.
  • Reduce odor and foul-smelling discharge.
  • Help the patient with daily hygiene when the patient is not capable.
  • Improve well-being for the patient.

Supplies

  • Drape 
  • Basin with lid
  • Sodium chloride 0.9 mg/ml, 500 ml bag. Or, 1 L boiled water with 1 tablespoon salt.
  • If there is an odor, a doctor can prescribe a special vinegar solution.
  • Transfer adapter
  • Compresses
  • Gloves
  • Sanitary pad/diaper

Preparation

  • Inform the patient about the procedure.
  • Give pain medication if needed.
  • The saline bag is warmed to body temperature by placing it in warm water. 
  • If prescribed, a vinegar solution is used.
  • Attach the transfer adapter to the salt water bag.
  • Check the temperature of the saline before using.
  • The patient lies in the lithotomy position. Make her as comfortable as possible. 
  • Place a drape under the patient.   
  • The basin is placed under the patient to catch fluid while the rinse fluid is poured over the vulva.

Implementation

  • It is important to perform rinsing carefully because it may be uncomfortable and painful. 
  • Hold the outer labia to the sides with one hand. 
  • Hold the saline bag in the other hand and press carefully. Let some of the saline rinse the inside of the thigh to prepare the patient, then direct the stream toward the vulva.
  • Make sure the tip of the adapter does not touch the patient. 
  • If the patient is not sore, but has necrosis, increase the pressure of the stream to remove some of the necrosis, or gently use a moist compress. 
  • Remove the basin from under the patient as soon as rinsing is finished.
  • Carefully dry with compresses.
  • Change to new diaper or pad.
  • Patients receiving external radiation therapy should be allowed to air-dry.
  • The patient lies in the same position as during rinsing.
  • Cover the patient with a blanket.
  • The patient should remain lying down for about 20 minutes. 
  • The patient should avoid tight-fitting clothes.

Follow-up

Observe for:

  • Bleeding
  • Odor 
  • Discharge

A doctor should be contact if there is increasing discharge, bleeding, or foul odor. 


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