090 Vaginal Dilation: Current Use and Treatment Practices Vaginal Dilator Clinician Survey: Preliminary Report Health Care Provider Insight

Vaginal dilators are recommended and used for many clinical indications including but not limited to dyspareunia, pelvic floor hypertonus and vulvar vestibulitis. Online clinician and patient surveys were created to ascertain further information concerning dilators and their practical implications in clinical practice. Two online clinical surveys were created in order to ascertain detailed information concerning practical and clinical information with respect to dilator use. Participants received a small financial remuneration, $10 Starbucks gift card, for their time. We present the first 96 clinicians and 40 patients who completed the survey from July 2 to and including September 21, 2015. The preliminary report consisted of 96 respondents (89 female; 7 male) who were in clinical practice for an average of 15.9 years. The majority were physical therapists (70.8%) 67/96; and 21 were medical doctors. The most common indication for prescribing dilators was for painful intercourse and vaginismus. Approximately 14% of those surveyed prescribed over 100 dilators per year whereas 16% prescribed approximately fifty. Health care professionals estimated their success rate as measure by painless penetration at 71% and that patients achieved success on average 4.7 months after starting their dilator program. Clinicians estimated that 80% of their patients had suffered from their medical conditions for 2 years or greater before seeking treatment with 20% suffering for 5 years or longer. Most HCP instruct patients to use dilators every other day and follow up is commonly 2-4 weeks with only 8.3 % following up every 3 months. Half are instructed to use dilators at night and the other half are instructed to use them whenever they feel comfortable in their scheduling. In 80% of the time patients are taught mindfulness, 57% of the time meditation and more than half are instructed to listen to calming music during dilator exercises. The most common reasons for non-compliance is perceived to be – lack of privacy, pain during use, fatigue and dilators being cumbersome. HCP report patient commonly expressed emotions are anxiety, hopeful, empowered, embarrassed and frustration. 77% of HCP would consider selling dilators through their office.