title: Female sexual function after abdominoperineal resection for squamous cell carcinoma of the anus and the specific influence of colpectomy and vertical rectus abdominis myocutaneous flap.
abstract: OBJECTIVE
  Abdominoperineal resection (APR) is the only curative treatment for recurrent or persisting squamous cell carcinoma of the anus after radiochemotherapy. A vertical rectus abdominis myocutaneous (VRAM) flap reduces perineal morbidity. The sexual life (SL) of women after APR is unknown. Aims of this study were to evaluate SF of women after APR.
  
  
  METHODS
  47 women alive after APR performed between 1996 and 2007 were included. SL was evaluated using the female sexual function index (FSFI) score.
  
  
  RESULTS
  29 (62%) women answered the questionnaire: 15 (52%) had a VRAM and 16 (55%) a colpectomy. Among the 21 patients with SL before surgery, 16 (76%) still had intercourse with a mean FSFI score of 19.5 ± 10.9 [4.8-36]. Main difficulties reported were troubles of lubrication, orgasm, and dyspareunia. Confection of a VRAM did not influence the recovery of SL (P = 0.717). Colpectomy reduced return of SL (P = 0.026).
  
  
  CONCLUSIONS
  Among women who had SL before APR, 76% still had sexual intercourse after. Colpectomy seems to reduce SL.
authors.affiliation: Department of Digestive Surgery, Hospital Saint-Antoine AP-HP, University Pierre et Marie Curie, Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Corte
authors.forename: J H
authors.initials: JH
authors.lastname: Lefèvre
authors.forename: N
authors.initials: N
authors.lastname: Dehnis
authors.forename: C
authors.initials: C
authors.lastname: Shields
authors.forename: M
authors.initials: M
authors.lastname: Chaouat
authors.forename: E
authors.initials: E
authors.lastname: Tiret
authors.forename: Y
authors.initials: Y
authors.lastname: Parc
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D001828:Body Image; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery*; D003075:Coitus / Q000502:physiology / Q000523:psychology; D004414:Dyspareunia / Q000209:etiology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009948:Orgasm; D010502:Perineum / Q000601:surgery; D017568:Rectus Abdominis / Q000601:surgery; D012677:Sensation; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000503:physiopathology; D019529:Sexuality / Q000502:physiology / Q000523:psychology; D013524:Surgical Flaps / Q000009:adverse effects*; D014621:Vagina / Q000503:physiopathology / Q000601:surgery*