Share this article on:

Psychologic, Relational, and Sexual Functioning in Women After Surgical Treatment of Vulvar Malignancy: A Prospective Controlled Study

Aerts, Leen MD*; Enzlin, Paul PhD†‡; Verhaeghe, Johan MD, PhD*; Vergote, Ignace MD, PhD*; Amant, Frédéric MD, PhD

International Journal of Gynecological Cancer: February 2014 - Volume 24 - Issue 2 - p 372–380
doi: 10.1097/IGC.0000000000000035
Quality of Life

Objective Vulvectomy for vulvar malignancy can affect sexual functioning based on anatomic, physiologic, psychologic, and relational mechanisms. The aims of this study were to prospectively investigate sexual adjustment of women with vulvar malignancy during a follow-up period of 1 year after vulvectomy and to compare the results with healthy control women.

Methods In this prospective controlled study, participants completed the Beck Depression Inventory scale, World Health Organization-5 Well-being scale, Dyadic Adjustment Scale, Short Sexual Functioning Scale, and Specific Sexual Problems Questionnaire to assess various aspects of psychosocial and sexual functioning just before surgery, 6 months, and 1 year after treatment.

Results Twenty-nine women with vulvar malignancy and 29 healthy controls completed the survey. Compared with the presurgery status, no significant differences were found in psychologic, relational, and sexual functioning in women after surgery for vulvar malignancy. Compared with healthy control women, women with vulvar malignancy reported significantly lower psychologic well-being and quality of partner relationship, both before and after treatment. Moreover, significantly more patients with vulvar malignancy reported preoperative and postoperatively sexual dysfunctions than healthy controls, including entry and deep dyspareunia, abdominal pain during intercourse, reduced ability to achieve orgasm, and reduced intensity of orgasm.

Conclusions This prospective study yielded no differences in psychosocial and sexual functioning for women with vulvar malignancy before and after vulvectomy. However, when compared with healthy controls, patients with vulvar malignancy are at high risk for sexual dysfunctions, both before and after surgical treatment.

*Department of Obstetrics and Gynecology, University Hospitals Leuven; †Centre for Couple, Family, and Sex Therapy, University Psychiatric Centre, and ‡Department of Development and Regeneration, Institute for Family and Sexuality Studies, Catholic University in Leuven, Belgium; and §Research Fund Flanders, Brussels, Belgium.

Address correspondence and reprint requests to Leen Aerts, MD, Department of Gynecology, University Hospitals Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium. E-mail:

This study was supported by a grant from Kom op tegen Kanker.

The authors declare no conflicts of interest.

Received August 8, 2013

Received in revised form October 10, 2013

Accepted October 17, 2013

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.