Vault brachytherapy: what should you know?

The vaginal vault is the upper end of the vagina, often after surgery to remove the womb. A specialist places an applicator in the vault so radiation can reach nearby tissue while limiting exposure to areas farther away. The applicator is connected to an afterloader, which moves the radioactive source into position for the planned treatment and then withdraws it.

Treatment may be considered for selected cervical, womb or vaginal cancers, depending on the diagnosis and previous treatment. The applicator is usually removed after each session, so it does not remain in the body between visits.

Your team will explain positioning, bladder or bowel preparation if needed, and whether you should avoid eating or drinking before the appointment. Tell them about pregnancy possibility, bleeding, infection symptoms, allergies and medicines that affect bleeding. Wear comfortable clothing and arrange support if sedation or anaesthesia is planned.

During placement, pressure or cramping can occur. After treatment, mild soreness, discharge or spotting may happen. Follow the team’s instructions about bathing, intercourse, tampons and follow-up examinations, because healing and restrictions vary.

Contact your treatment team promptly for heavy bleeding, fever, worsening pelvic pain, foul-smelling discharge, difficulty passing urine or new bowel problems. Seek emergency help for severe pain, collapse or uncontrolled bleeding.

Ask why vault brachytherapy is recommended, how the applicator will be placed, whether anaesthesia is needed, how many visits are planned, and which symptoms should be reported. Ask how treatment may affect vaginal comfort, sexual activity and future examinations.