title: Long-term sexual function in survivors of vulvar cancer: a cross-sectional study.
abstract: OBJECTIVE
  To assess sexual function of vulvar cancer survivors who received extensive and less extensive treatment. To explore associations between sexual function and patient, disease, treatment, and psychological variables.
  
  
  METHODS
  Sexual function (Female Sexual Function Index, FSFI), mental and physical well-being (SF36 Health Survey), body image (Body Image Scale), and optimism (Life Orientation Test) were assessed in vulvar cancer survivors treated in the period January 1997-January 2007. Demographic, disease and treatment characteristics were collected from medical files. Radical local excision with inguinal lymph node dissection and radical vulvectomy were considered extensive treatments; radical local excision, with or without sentinel node dissection, was considered less extensive treatment. Univariate and multivariate linear regression analyses were performed.
  
  
  RESULTS
  Of 120 eligible patients, 76 (63%) responded. Eighteen women with a male partner (43%) reported having sexual intercourse. FSFI domain scores did not differ between extensively and less extensively treated women. Age was negatively associated with "Arousal" and "Desire", having a partner was positively associated with "Satisfaction", and optimism and physical well-being were positively associated with "Desire" and "Orgasm". Adjuvant inguinal radiotherapy was negatively associated with "Orgasm". One woman reported having better sexual function after than before treatment, 50% reported a similar sexual function, and 42% a worse sexual function.
  
  
  CONCLUSIONS
  43% of women who survived vulvar cancer and who had a male partner were sexually active. Treatment-related variables had a limited influence on long-term sexual function in these patients. Having a partner, good physical well-being, and being optimistic were positively associated with sexual function.
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands. m.h.hazewinkel@amc.uva.nl
authors.forename: Menke H
authors.initials: MH
authors.lastname: Hazewinkel
authors.forename: Ellen T M
authors.initials: ET
authors.lastname: Laan
authors.forename: Mirjam A G
authors.initials: MA
authors.lastname: Sprangers
authors.forename: Guus
authors.initials: G
authors.lastname: Fons
authors.forename: Matthé P M
authors.initials: MP
authors.lastname: Burger
authors.forename: Jan-Paul W R
authors.initials: JP
authors.lastname: Roovers
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological; D017741:Survivors; D014846:Vulvar Neoplasms / Q000503:physiopathology* / Q000601:surgery*