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Postoperative Sexual Concerns and Functioning in Patients Who Underwent Lysis of Vulvovaginal Adhesions

Suzuki, Veronica MD1; Haefner, Hope K. MD2; Piper, Claudia Kraus ACSW2,3; O’Gara, Casey RN, ACSW2,3; Reed, Barbara D. MD, MSPH4

Journal of Lower Genital Tract Disease: January 2013 - Volume 17 - Issue 1 - p 33–37
doi: 10.1097/LGT.0b013e318252d347
Original Articles

Objective: This study aimed to determine satisfaction and functioning before and after surgery among women with lichen planus, who have undergone lysis of vulvovaginal adhesions, and to compare their sexual functioning with those of women without this disorder.

Materials and Methods: The study was approved by the University of Michigan Internal Review Board. A retrospective self-administered survey was completed by 22 women (50–76 years). Eleven women who had undergone surgery to release vulvovaginal adhesions from lichen planus answered a mailed, 75-item questionnaire about health, sexual functioning (using the Female Sexual Function Index), and satisfaction with surgical outcomes 6 months to 6 years after their lysis of vulvovaginal adhesions followed by long-term vaginal dilation. They were compared with 11 age-matched normal controls. We used descriptive statistics such as mean and SDs to describe the population and χ2 and t tests to determine significant differences between groups.

Results: Surgery in women with lichen planus scarring allowed intercourse in 55% and decreased urination difficulties in 75%. Of the patients, 91% stated they were happy with the surgery and would recommend it to others. However, sexual difficulties may persist even after surgery. Approximately 50% of the patients continue to fear pain. There continues to be differences between cases and controls in sexual discomfort and sexual satisfaction.

Conclusions: After surgery for lichen planus, women tend to be more likely to have intercourse, to have less urinary symptoms or infections, and to have fewer genital symptoms. However, for some, sexual difficulties persisted. It may be wise to consider sexual counseling for this population. Nevertheless, most of the patients stated that they were happy with the surgery and would recommend it to others.

Lichen planus of the vagina can result in significant scarring that can be successfully treated with lysis of adhesions, postoperative dilation, and intravaginal steroids.

1Hospital de Clínicas “José de San Martín,” University of Buenos Aires, Argentina; 2Departments of Obstetrics and Gynecology, 3Social Work and 4Family Medicine,The University of Michigan Health System, Ann Harbor, MI

Correspondence to: Veronica Suzuki, MD, Department of Obstetrics and Gynecology, Hospital de Clínicas “José de San Martín,” University of Buenos Aires, 2351 Córdoba Av, (C1120AAF) Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina. E-mail: avsuzuki@gmail.com

The authors declare they have no conflicts of interest.

©2013The American Society for Colposcopy and Cervical Pathology