QUALITY OF LIFE AND URINARY FUNCTION AFTER RADICAL VULVECTOMY WITH OR WITHOUT FLAP REPAIR

Objective: The aim of this study was to evaluate quality of life and urinary function in patients submitted to vulvectomy with or without flap repair plastic reconstruction. Methods: One hundred thirty four patients diagnosed with vulvar carcinoma referred to our departments of Gynecology and Obstetrics between January 1997 and January 2009. Patients were divided in two groups: Group one consisted of 80 patients treated with radical vulvectomy or hemivulvectomy in combination with inguinal lymphadenectomy. Group two included 54 women treated with radical vulvectomy and inguinal bilateral lymphadenectomy associated with vulvar reconstruction with V-Y amplified sliding flap or island flap raised from gluteal folds. All patients were submitted to Vulvar Cancer Specific Sub Scale VWB questionnaire constituted of 15 items regarding quality of life, sexual function, body image and urinary function scored by 0 to 4; moreover urinary flow quality was evaluated. Results: Patient´s quality of life and aesthetic deficit was better in patients submitted to radical vulvectomy with plastic reconstruction. In particular we had detected better clinical conditions in Group two regarding self body image . Moreover, the depth and width of the vagina can be preserved by reconstructing the three dimensional structure of the vaginal wall which facilitates the follow up of these patients. Conclusions: Disfiguration of the external gentalia which are an important part of a women's identity has a strong negative effect on the patient's body appearance, therefore surgical reconstruction of the vulva improve morbidity and quality of life after treatment