title: Flap repair: an effective strategy for minimising sexual morbidity associated with the surgical management of vulval intra epithelial neoplasia.
abstract: OBJECTIVE
  To assess the sexual function after local excision and flap repair for symptomatic vulval intraepithelial neoplasia (VIN).
  
  
  METHODS
  A retrospective analysis of five sexually active women who had persistent, symptomatic VIN diagnosed in a dedicated tertiary referral vulval clinic and treated with local excision and flap repair. Sexual function was assessed using a modified version of the Sabbatsberg Sexual Self-Rating Scoring (SRS) system.
  
  
  RESULTS
  The mean age of the cohort was 32 years (range 30 to 51). Four patients had previously been unsuccessfully treated with local excision. Follow up ranged from 5 to 33 months. The SRS scores were 90, 90, 81, 72 and 25. Endogenous depression may explain this last score. There has been no recurrence of VIN.
  
  
  CONCLUSIONS
  In sexually active women with symptomatic VIN III, a flap reconstruction should be considered in addition to local excision as the treatment of choice.
authors.affiliation: Gynaecological Oncology Unit, Aberdeen Royal Infirmary, U.K.
authors.forename: G V
authors.initials: GV
authors.lastname: Narayansingh
authors.forename: G P
authors.initials: GP
authors.lastname: Cumming
authors.forename: D P
authors.initials: DP
authors.lastname: Parkin
authors.forename: D T
authors.initials: DT
authors.lastname: McConell
authors.forename: E
authors.initials: E
authors.lastname: Honey
authors.forename: P S
authors.initials: PS
authors.lastname: Kolhe
mesh_terms: D000328:Adult; D001828:Body Image; D002278:Carcinoma in Situ / Q000523:psychology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012725:Sexual Behavior / Q000523:psychology*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000523:psychology* / Q000601:surgery*