Correlates of sexual function following vulvar excision

doi:10.1016/j.ygyno.2007.01.027

Gynecologic Oncology

Volume 105, Issue 3, June 2007, Pages 600-603

https://doi.org/10.1016/j.ygyno.2007.01.027 Get rights and content

Abstract

Objectives

The objectives were to evaluate associations between size of excision, grade of VIN, demographic variables, location of excision and laterality and sexual function and quality of life (QOL) in women with vulvar intraepithelial neoplasia (VIN) following vulvar excision.

Methods

Forty-three women with VIN who had undergone a vulvar excision completed the Female Sexual Function Index (FSFI) and the European Organization for Research and Treatment of Cancer QLQ-C30 (QLQ C-30) scale to provide an assessment of sexual function and QOL. Medical records of the participants were reviewed for pathology results, operative reports, and medication history. Correlation and multiple regression analyses were performed to determine associations between collected variables and sexual function and QOL scores.

Results

Most participants (n = 43) were Caucasian (76.6%) and smoked (69.8%). Age significantly correlated with FSFI total score (Pearson r = − .470, p = .001), along with size of excision (r = − .412, p = .009). Neither VIN grade, location of excision, nor time since excision correlated with sexual function or QOL.

Conclusions

Older age and a more extensive vulvar excision were associated with poorer sexual function and QOL in women following surgical treatment for VIN. Further study with a larger sample and additional variables is needed to better understand the effect of vulvar excision on women's sexual function and QOL.

Introduction

The incidence of vulvar intraepithelial neoplasia (VIN) has doubled over the last two decades for all age groups and has tripled for women under the age of 50 [1]. The standard treatment for VIN is excision of the vulvar lesion and can range from a local excision to a vulvectomy with removal of the clitoris. These excisions lead to interruption of the normal vulvar structures. Despite the increasing incidence of VIN and the invasiveness of treatment, little is known about the relationships that exist between individual patient characteristics and sexual function.

Women may experience specific disruptions in the sexual phases of desire, arousal, resolution, and to a lesser extent, orgasm, following vulvar excision [2], [3], [4], [5], [6], [7]. Most women who report a satisfying sexual relationship before surgery report a decrease in sexual satisfaction following vulvar excision. There is little in the literature to assist in predicting which vulvar excision patients will have problems with sexual function following surgery or who will return to normal function. Women who are depressed at the time of surgery are more likely to have body image disturbances and sexual dysfunction following excision [4]. However there are inconsistencies in the literature regarding whether the size of the excision has a role in sexual function outcomes [2], [3], [4]. No other patient variables have been studied in relation to sexual function following vulvar excision.

The current study reports secondary data analysis findings from a study validating the Female Sexual Function Index as measure of sexual function in women following vulvar excision [8]. This study is an initial step in addressing the important question of what patient variables relate to sexual function following vulvar excision.

Section snippets

Methods

This study was approved by the University of Tennessee Health Science Center Institutional Review Board. Informed consent was obtained from all participants after an explanation of the study. Participants were recruited over a six-month period during routine visits to a gynecology oncology clinic after vulvar excision. Eligibility criteria included an age of 18 years or older, the ability to speak and read English, a vulvar excision greater than 1 cm, and sexual activity within the last year

Characteristics

A total of 43 women participated in the study. The average age of the participants was 47.46 with a range of 19–75 years. Most participants were Caucasian (76.6%) and were currently smoking (69.8%). About half of the participants were married (53.5%) and had a high school (41.9%) or college (44.2%) education.

Correlates with participant demographics

Among the demographic variables (i.e., race, age, marital status, education level, and smoking status), only age was significantly correlated with FSFI total (r = − .470, p = .001) for women who

Discussion

Our study found that as age increases sexual function and QOL scores decrease post vulvar excision. According to our multiple regression analysis, older women are at more risk for poor sexual function and QOL following vulvar excision. This emphasizes the need to assess for any preexisting problems with this age group and to discuss differences in normal changes in sexual function with aging from those that may be attributed to the excision.

No significant associations were found with sexual

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Sexual dysfunction following vulvectomy
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Correlates of sexual function following vulvar excision

Abstract

Objectives

Methods

Results

Conclusions

Introduction

Section snippets

Methods

Characteristics

Correlates with participant demographics

Discussion

Gynecol. Oncol.

Trends in vulvar neoplasia. Increasing incidence of vulvar intraepithelial neoplasia and squamous cell carcinoma of the vulva in young women

J. Reprod. Med.

Sexual functioning after treatment of in situ vulvar cancer: preliminary report

Obstet. Gynecol.

Sexual function and somatopsychic reactions after local excision of vulvar intra-epithelial neoplasia

Acta Obstet. Gynecol. Scand.

Quality of life and psychological state after radical vulvectomy

J. Psychosom. Obstet. Gynaecol.