Sexual, psychological, and relational functioning in women after surgical treatment for vulvar malignancy: a literature review.

INTRODUCTION: Vulvectomy is an intrusive treatment option for women with vulvar malignancy that theoretically may affect sexual function. AIM: This study aims to provide a comprehensive review of the literature on the impact of surgical treatment for vulvar malignancy on sexual functioning, overall quality of life, and partner relationship.
METHODS: Systematic search of the medical literature on PubMed, PsycINFO, Cochrane database, Google Scholar and Embase using a number of related terms including vulvar malignancy, vulvar cancer, vulva cancer, vulval cancer, vulvectomy, sexual function, partner relation, quality of life, and psychological functioning. MAIN OUTCOME MEASURE: Measures and indicators of sexual function, overall quality of life, and partner relationship following vulvectomy for vulvar malignancy.
RESULTS: There is evidence that women who undergo surgical treatment for vulvar cancer or vulvar intraepithelial neoplasia are at high risk for sexual dysfunctions, dissatisfaction with partner relationship, and psychological difficulties. Factors associated with posttreatment sexual dysfunction include patient's increased age, poor overall well-being, history of depression, anxiety, and excision size of vulvar malignancy.
CONCLUSIONS: Surgical treatment of vulvar cancer has a negative impact on sexual function, quality of life, and satisfaction with partner relationship. However, hitherto only little research effort has been directed to postoperative sexual well-being in vulvar cancer survivors. There is a need for more methodological sound prospective studies that explore sexual function, quality of life, and partner relationship and its predictors over time in vulvar cancer patients.