Perineoplasty for the treatment of introital stenosis related to vulvar lichen sclerosus.
OBJECTIVE
The objective of this study is to assess the usefulness of perineoplasty for introital stenosis related to vulvar lichen sclerosus.


METHODS
The records of 64 patients who underwent perineoplasty for this indication were reviewed retrospectively. The median age of patients was 49 years, and the median duration of lichen sclerosus was 60 months. Ninety percent of patients complained of dyspareunia. Patient satisfaction with the outcome was assessed by means of a questionnaire. Persistence of dyspareunia and impaired quality of sexual intercourse were considered as treatment failure. Risk factors of failure that were evaluated included duration of lichen sclerosus, age, previous topical steroid therapy, previous perineotomy, time since surgery, and histologic stage. Statistical analysis was performed by use of Fisher exact test.


RESULTS
Of the 64 patients, 12 were lost to follow-up and 2 patients did not respond to the questionnaire. Perineoplasty improved dyspareunia in 45 of the 50 patients (90%) and quality of sexual intercourse in 43 of 50 patients (86%). None of the risk factors evaluated were associated with failure of perineoplasty.


CONCLUSIONS
Perineoplasty provides good functional results for women with introital stenosis related to vulvar lichen sclerosus.
Rouzier
Roman
R
Department of Obstetrics and Gynecology, CHI Créteil, France.
Haddad
Bassam
B
Deyrolle
Caroline
C
Pelisse
Monique
M
Moyal-Barracco
Micheline
M
Paniel
Bernard-Jean
BJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003075:Coitus; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000150:complications*; D008875:Middle Aged; D017060:Patient Satisfaction; D010502:Perineum / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014623:Vaginal Diseases / Q000209:etiology* / Q000601:surgery; D014845:Vulvar Diseases / Q000150:complications*