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Objective: To explore women's experiences with vulvar intraepithelial neoplasia during diagnosis and treatment., Design: Two focus groups, each with 3 participants, were conducted as a pilot study. Participants were asked open-ended questions about their experiences, quality of life, sexual functioning, body image, and well-being. Responses were audio taped, transcribed, and independently analyzed by 2 researchers to identify themes and develop categories of the participants' experiences., Setting: Participants were recruited from an urban oncology clinic., Patients/participants: The study population consisted of 6 White women ranging in age from 22 to 72 years., Methods: Participants with a diagnosis of vulvar intraepithelial neoplasia were recruited using flyers posted in their oncologist's office. An interview guide was used focusing on participants' experiences., Results: Participants described a cyclic journey with vulvar intraepithelial neoplasia related to the recurrent nature of the disease. Two internal influences on the journey were described: spirituality and time in life. Five external influences were discussed: significant others, health care providers, family, friends, and others with vulvar intraepithelial neoplasia., Conclusion: Health care providers cannot alter the recurrent nature of vulvar intraepithelial neoplasia; however, they can better understand a woman's experience and the variables that impact her experience in a negative or positive way.

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.

Objective: To compare sexualfunction and quality of life (QOL) in women with vulvar excision for vulvar intraepithelial neoplasia (VIN) with those in an age-matched, healthy comparison group., Study Design: This cross-sectional study contrasted women (n = 43) after vulvar excision for VIN with a healthy comparison group (n = 43). Participants were asked to complete the Female Sexual Function Index (FSFI) and the European Organization for Research and Treatment of Cancer QLQ-C30 to provide an assessment of sexual function and quality of life. Medical records of the participants were reviewed for pathology results, operative reports and medication history. Women with VIN were age matched +/- 2 years with healthy women attending a breast screening clinic., Results: Most participants were Caucasian (76.6%) and smoked (69.8%). Women after excision had poorer scores in sexual function (p = 0.015) and QOL (p = 0.003) than healthy women., Conclusion: Impairment of sexual function after vulvar excision for VIN appears to be of the psychologic domain, providing hope that counseling can have a meaningful impact for these women.

The present investigation extends the validation of the Female Sexual Function Index (FSFI; Rosen et al., 2000) to include women with vulvar excisions for vulvar intraepithelial neoplasia (VIN). No instrument previously has been validated in this population. We administered the instrument to 43 women (n = 43) with VIN treated with vulvar excision and age-matched healthy controls (n = 43). We found the FSFI to have high reliability and validity in the VIN excision population. Discriminant validity and internal consistency were within acceptable ranges. Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C-30; Agronson et al., 1993) and the FSFI in this population, we found a correlation between a related construct of quality of life and sexual function.