title: Motives for Vulvar Surgery of Women with Lichen Sclerosus.
abstract: BACKGROUND
  Women with lichen sclerosus (LS) may experience (superficial) dyspareunia or the inability to have vaginal intercourse due to painful fissures and narrowing of the vaginal introitus. A surgical procedure may contribute to the relief of these sexual pain problems. It is unknown what motives women have to undergo surgery in order to regain the ability to have sexual intercourse. Such knowledge can offer important insights that are indispensable when discussing the option of vulvar surgery with patients with LS and might prevent potential patient dissatisfaction. This study's purpose is to examine why women with LS decide to undergo vulvar surgery in order to restore intercourse.
  
  
  METHODS
  Nineteen women with anogenital LS participated in audiotaped qualitative individual interviews, in which their motives for undergoing vulvar surgery to restore intercourse were explored retrospectively. Interview data were analyzed using the constant comparative method.
  
  
  RESULTS
  Three main motives for wanting to undergo surgery in order to restore intercourse were found. These were the desire to be a "normal" woman, the desire to sexually satisfy the male partner, and the desire to regain the experience of intimacy and sexual enjoyment. Another reason for surgery was to reduce daily life LS symptoms. The sexual pain complaints prevented the women from living up to their norms about heterosexuality and gender roles. Being unable to have intercourse led women to feel inadequate as a woman and as a sexual partner.
  
  
  CONCLUSIONS
  Women with LS may opt for surgery to restore their identity as a "normal" woman and sexual partner, to regain the experience of coital intimacy, and to be less bothered by LS symptoms in daily life. The present findings point to the importance of a thorough couple-based sexual history in which women's motives for and expectations of vulvar surgery will be explored in order to facilitate a good decision and to increase treatment satisfaction.
authors.affiliation: Department of Sexology and Psychosomatic Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Marieke
authors.initials: M
authors.lastname: Brauer
authors.affiliation: Department of Sexology and Psychosomatic Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Rik
authors.initials: R
authors.lastname: van Lunsen
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Matthé
authors.initials: M
authors.lastname: Burger
authors.affiliation: Department of Sexology and Psychosomatic Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Ellen
authors.initials: E
authors.lastname: Laan
mesh_terms: D000328:Adult; D000368:Aged; D004414:Dyspareunia / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010549:Personal Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D012725:Sexual Behavior; D012747:Sexual Partners / Q000523:psychology*; D007724:Vulvar Lichen Sclerosus / Q000150:complications* / Q000523:psychology* / Q000601:surgery
keywords: Dyspareunia; Lichen Sclerosus; Motives; Qualitative Design; Sexual Dysfunction; Vulvar Surgery