For a patient with vaginal adhesions/stenosis, do you recommend any other therapy besides a dilator?

Yes! In patients who have received radiation and have stenosis I frequently given topical estrogen cream with their dilators to help prevent or treat vaginal stenosis. My patents report that it helps with the pain associated with vaginal atrophy when they try to use their dilator. I treat a lot of cervical cancer patients who with definitive doses of radiation find the most benefit from topical estrogen and dilators. There is old data that supports this (PMID:6108259) as well as new information (PMID:28496367).