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.

Vincent Lavoué 1, 2, * A. Lemarrec 1 N. Bertheuil 3 Sébastien Henno 4 Habiba Mesbah 2 Eric Watier 3 Jean Levêque 1, 2 Karine Morcel 1
* Auteur correspondant
1 Service de Gynécologie et Obstétrique [Rennes]
2 CRLCC - CRLCC Eugène Marquis
3 Service de chirurgie plastique, reconstructive et esthétique
4 Service d'anatomie et cytologie pathologiques [Rennes]
Abstract : 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.
Keywords : Vulvectomy Skin graft Vulvar intraepithelial neoplasia Vulvar Paget disease Quality of life
Type de document :
Article dans une revue
EJSO - European Journal of Surgical Oncology, WB Saunders, 2013, 39 (12), pp.1444-50. 〈10.1016/j.ejso.2013.09.014〉
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Soumis le : mercredi 9 octobre 2013 - 09:42:26
Dernière modification le : mercredi 16 mai 2018 - 11:24:04
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Vincent Lavoué, A. Lemarrec, N. Bertheuil, Sébastien Henno, Habiba Mesbah, et al.. 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.. EJSO - European Journal of Surgical Oncology, WB Saunders, 2013, 39 (12), pp.1444-50. 〈10.1016/j.ejso.2013.09.014〉. 〈inserm-00871204〉

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