What is the best option for patients with fibrosis and stenosis after cervical cancer brachytherapy?

Unfortunately, none of the lasers do not work well on fibrosis after brachytherapy. I know this is a frustrating problem. I think your best best is using graduated dilators and lots of lube and patience. I skilled pelvic floor therapist can be very helpful.

Regular use of vaginal dilators, frequently in conjunction with topical estrogen therapy to help improve vaginal tissue health and lubrication, is the primary treatment for vaginal stenosis following radiation and brachytherapy for cervical cancer. Sexual activity can also help prevent stenosis by gently stretching the vaginal canal. Following radiation therapy, vaginal fibrosis and stenosis cannot be reversed.

Lasers work for vaginal atrophy, not for radiation induced fibrosis and stenosis. The radiation burns off the superficial skin layers and a thick layer of permanent scar tissue develops. Layering this tissue doesn't make it stretch or soften. It's an irreversible condition.