*Department of Obstetrics and Gynecology, University Hospitals Leuven; †Centre for Couple, Family, and Sex Therapy, University Psychiatric Centre, and ‡Department of Development and Regeneration, Institute for Family and Sexuality Studies, Catholic University in Leuven, Belgium; and §Research Fund Flanders, Brussels, Belgium.
Int J Gynecol Cancer. 2014 Feb;24(2):372-80. doi: 10.1097/IGC.0000000000000035.
Vulvectomy for vulvar malignancy can affect sexual functioning based on anatomic, physiologic, psychologic, and relational mechanisms. The aims of this study were to prospectively investigate sexual adjustment of women with vulvar malignancy during a follow-up period of 1 year after vulvectomy and to compare the results with healthy control women.
In this prospective controlled study, participants completed the Beck Depression Inventory scale, World Health Organization-5 Well-being scale, Dyadic Adjustment Scale, Short Sexual Functioning Scale, and Specific Sexual Problems Questionnaire to assess various aspects of psychosocial and sexual functioning just before surgery, 6 months, and 1 year after treatment.
Twenty-nine women with vulvar malignancy and 29 healthy controls completed the survey. Compared with the presurgery status, no significant differences were found in psychologic, relational, and sexual functioning in women after surgery for vulvar malignancy. Compared with healthy control women, women with vulvar malignancy reported significantly lower psychologic well-being and quality of partner relationship, both before and after treatment. Moreover, significantly more patients with vulvar malignancy reported preoperative and postoperatively sexual dysfunctions than healthy controls, including entry and deep dyspareunia, abdominal pain during intercourse, reduced ability to achieve orgasm, and reduced intensity of orgasm.
This prospective study yielded no differences in psychosocial and sexual functioning for women with vulvar malignancy before and after vulvectomy. However, when compared with healthy controls, patients with vulvar malignancy are at high risk for sexual dysfunctions, both before and after surgical treatment.
外阴恶性肿瘤的外阴切除术会通过解剖学、生理学、心理学和关系机制影响性功能。本研究的目的是前瞻性调查外阴恶性肿瘤女性患者在接受外阴切除术 1 年随访期间的性适应情况，并将结果与健康对照组进行比较。
在这项前瞻性对照研究中，参与者在手术前、术后 6 个月和 1 年分别完成贝克抑郁量表、世界卫生组织 5 项幸福感量表、夫妻适应量表、简短性功能量表和特定性功能问题问卷，以评估心理社会和性功能的各个方面。
29 名患有外阴恶性肿瘤的女性和 29 名健康对照组完成了调查。与术前状态相比，外阴恶性肿瘤手术后女性的心理、关系和性功能没有显著差异。与健康对照组女性相比，患有外阴恶性肿瘤的女性在治疗前后的心理幸福感和伴侣关系质量都较低。此外，患有外阴恶性肿瘤的女性报告术前和术后性功能障碍的比例明显高于健康对照组，包括进入和深部性交痛、性交时腹痛、性高潮能力下降和性高潮强度下降。
这项前瞻性研究在外阴恶性肿瘤女性外阴切除术前后的心理社会和性功能方面没有差异。然而，与健康对照组相比，患有外阴恶性肿瘤的患者在手术前后都存在较高的性功能障碍风险。
