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#612 Reconstructive surgery in the treatment of vulvar stenosis after radical interventions in patients with vulvar cancer
  1. Elena Leontyevna Dikareva,
  2. Oksana Aslanovna Zhamborova,
  3. Amina Dzharbaevna Dzharbaeva,
  4. Veronika Andreevna Artemenko,
  5. Igor Evgenyevich Govorov and
  6. Elena Alexsandrovna Ulrikh
  1. Almazov National Medical Research Centre, Saint-Petersburg, Russia


Introduction/Background Surgery remains the most efficient method in treatment of vulvar cancer. With a locally advanced disease, extensive operations are required leading to gross scarring of the perineal tissues, vaginal stenosis, dysuric phenomena, pain, and altered sexual life.

Methodology We propose a method for surgical correction of cicatricial changes of the perineum in patients with malignant neoplasms of the vulva following radical vulvectomy.

Results Since 2018, 8 patients have been admitted to the Almazov National Research Medical Center with complaints of impaired urination (delay, soreness, difficulty, stream deviation), pain in the perineum, and altered sexual function caused by gross scarring in the perineum. All patients (n = 8) had previously undergone radical vulvectomy due to vulvar cancer, three along with postoperative radiation therapy. The average period from surgery to the occurrence of clinically significant changes was 5.8 years, with the earliest manifestations occurring after 21 months in one patient. All patients had a history of drug and/or photodynamic therapy without effect. We performed excision of scar-altered perineal tissues with simultaneous wound defect reconstruction with moved skin-fascial flaps from the posterior thighs’ surfaces. In all cases (n = 8), there were no signs of necrosis or flap ischemia. The use of this surgical method for closing a wound defect (figure 1) minimized the likelihood of postoperative complications leading to the formation of scar tissue changes in the perineum and significantly improved the quality of life of patients, the assessment of which was carried out using FACT-G questionnaires (Version 4, 2002).

Abstract #612 Figure 1

Reconstructive surgery with fasciocutaneous flaps after excision of scar-altered perineal tissues. Patient 63 years old, vulvar cancer St II. In 2008, radical vulvectomy, postoperative radiation therapy. (before reconstructive surgery, after surgery, 12 months after surgery)

Conclusion The use of reconstructive plastic surgery with moved fasciocutaneous flaps from the posterior surfaces of the thighs after excision of scar-altered perineal tissues to correct scarring of perineal tissues after vulvectomy is a promising method of treatment.

Disclosures Nothing to disclose

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