1. Quality of life and female sexual function after skinning vulvectomy with split-thickness skin graft in women with vulvar intraepithelial neoplasia or vulvar Paget disease
- Author
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Eric Watier, Karine Morcel, Sébastien Henno, Jean Levêque, Habiba Mesbah, A. Lemarrec, Vincent Lavoué, N. Bertheuil, Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], CRLCC Eugène Marquis (CRLCC), Service de chirurgie plastique, reconstructive et esthétique [Rennes] = Cosmetic Reconstructive and Plastic surgery [Rennes], Service d'anatomie et cytologie pathologiques [Rennes] = Anatomy and Cytopathology [Rennes], and Le Corre, Morgane
- Subjects
MESH: Sexual Behavior ,medicine.medical_treatment ,MESH: Paget Disease, Extramammary ,0302 clinical medicine ,Quality of life ,Surveys and Questionnaires ,MESH: Aged ,education.field_of_study ,MESH: Middle Aged ,030219 obstetrics & reproductive medicine ,Vulvar Neoplasms ,Incidence (epidemiology) ,Skin Transplantation ,General Medicine ,Middle Aged ,Vulvar Paget disease ,3. Good health ,Paget Disease, Extramammary ,Oncology ,030220 oncology & carcinogenesis ,Vulvectomy ,Population study ,Female ,MESH: Neoplasm Recurrence, Local ,Carcinoma in Situ ,Adult ,Skin graft ,medicine.medical_specialty ,Sexual Behavior ,Population ,Disease-Free Survival ,03 medical and health sciences ,Vulvar intraepithelial neoplasia ,medicine ,Humans ,education ,Aged ,Retrospective Studies ,MESH: Carcinoma in Situ ,MESH: Humans ,business.industry ,MESH: Questionnaires ,MESH: Quality of Life ,MESH: Adult ,MESH: Retrospective Studies ,[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,Retrospective cohort study ,medicine.disease ,[SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,MESH: Vulvar Neoplasms ,Surgery ,MESH: Disease-Free Survival ,MESH: Skin Transplantation ,Neoplasm Recurrence, Local ,Sexual function ,business ,MESH: Female - Abstract
International audience; OBJECTIVE: Vulvar intraepithelial neoplasia (VIN) and vulvar Paget disease are managed with either vulvectomy, destructive treatments (laser, antimitotic drugs) or immunostimulants. All these options are associated with functional complications. The purpose of this study was to evaluate the surgical technique consisting of skinning vulvectomy with split-thickness skin graft, and its effect on overall quality of life and sexual function. METHODS: A retrospective study was conducted on thirteen patients who underwent skinning vulvectomy with split-thickness skin graft between 1999 and 2009. Overall quality of life and sexual function were assessed with the Medical Outcome Study Short Form 36 (MOS SF-36) and Female Sexual Function Index (FSFI), respectively. RESULTS: The median age of patients was 54 (range: 33-77) years. Three patients had Paget disease and 10 patients had VIN lesions. The excision margins were clear in 46% of cases. The incidence of occult cancer was 31%. The mean follow-up period was 77 (±35) months. Four patients experienced a relapse of their intraepithelial disease. The mean disease-free survival was 58 (±44) months. There was no significant difference in MOS SF-36 scores between the study population and the general population. The patients assessed with the FSFI regained normal sexual function after the surgical procedure. CONCLUSION: Skinning vulvectomy with split-thickness skin graft is a feasible technique yielding good results in terms of quality of life and sexual function. It enables occult cancer to be diagnosed in patients with VIN or Paget disease.
- Published
- 2013
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