Geburtshilfe Frauenheilkd 2014; 74 - PO_Onko05_15
DOI: 10.1055/s-0034-1388417

Sexual activity and function in patients with preinvasive and invasive vulvar lesions after completed treatment

D Grimm 1, O Brummer 2, C zu Eulenburg 3, F Gieseking 4, AK Schliedermann 1, F Trillsch 1, S Mahner 1, L Woelber 1
  • 1Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • 2Department of Gynecology and Gynecologic Oncology, Asklepios Clinic Hamburg-Altona, Hamburg, Germany
  • 3Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  • 4Department of Gynecology and Endokrinology, Endokrinologikum Hamburg, Hamburg, Germany

Background: Sexual activity (SA) and function (SF) are central outcome measures in women affected by preinvasive and invasive vulvar lesions. Data on SA and SF after completed treatment are scares.

Methods: Validated questionnaires including the Female Sexual Function Index (FSFI-d) were provided to 166 women who were surveyed after completion of primary therapy for preinvasive and invasive vulvar lesions at the University Medical Center Hamburg-Eppendorf and Asklepios Medical Clinic Altona between March 2011 and June 2012. Furthermore patients could assess the questionnaires online via homepage of the Vulvar Cancer Support Group (n = 14).

Results: With an overall response rate of 32%, 24 patients with preinvasive and 34 with invasive lesions were evaluable. Median age was 54 years, with 34 (58.6%) patients being postmenopausal. Median time since completion of treatment was 17 months. All women underwent vulvar surgery (laser/cold knife/combination). Overall, 15 (25.9%) women reported no SA during the last 4 weeks. SA and SF was similar in patients with invasive and preinvasive lesions. Additional analyses contrasting surgical treatment methods yielded no significant differences. Time since surgery did not affect SA and SF. Age, however, was negatively associated to all dimensions of the FSFI-d [desire (p = 0.002), arousal (p < 0.001), lubrication (p < 0.001), orgasm (p = 0.001), satisfaction (p = 0.027), pain (p < 0.001)].

Conclusion: Women who regain sexual activity after treatment of vulvar lesions have a good overall sexual outcome; the results might however be biased by selection with a response rate of 32%. Age is one the most powerful factor influencing SA and SF.