Conservative Surgery for Vulvar Cancer Leaves Sexuality and Body Image Intact

A small study of 10 women indicated that conservative surgery for vulvar cancer had little to no long-term disruption of a woman’s sexuality or body image.

"The findings indicate surprisingly good outcomes for sexuality and body image in women having conservative surgery for early-stage vulvar cancer and support the concept of performing the most conservative vulvar resection consistent with cure of their disease," said one of the authors Ellen Barlow, RN, of The Royal Hospital for Women in Australia, in a statement.

The research, which was based on semi-structured in-depth interviews with the 10 women who underwent the surgery to remove sections of their external genitalia, was published in the Journal of Advanced Nursing. The women, with a mean age of 58 years, were interviewed from June to October 2009. The women’s experiences of sexuality and body image postsurgery were among the emerging themes discovered in a review of the interview transcripts.

Women's sexual satisfaction was affected more by intimacy and relationship status than physical arousal, the researchers reported. Women tended to feel negative emotions if they experienced more radical vulvar excision, multiple vulvar procedures, or swelling of the lower limbs as a complication of surgery, the authors said. Some women expressed fear of possible removal of their clitoris, and all sexually active women indicated their fear of pain once they resumed having sexual intercourse.

Still, the authors said there is a need for improving communication with patients about sexuality and body image, and specifically about the resumption of sexual intercourse, with women having the surgery. They stressed that women should be provided information on how to prevent or alleviate sexual issues that may arise as a consequence of their treatment.

Pertinent Points:
- Conservative surgery for vulvar cancer had little to no long-term disruption to a woman’s sexuality or body image.
- Because of high survival rates for women with early stages of the disease, it is important to discuss the issues of sexuality and body image with patients undergoing the surgery.

References:

Barlow EL, Hacker NF, Hussain R, Parmenter G. Sexuality and body image following treatment for early-stage vulvar cancer: a quantitative study. J Adv Nurs. 2014;doi:10.1111/jan.12346. [Epub ahead of print]