Vulval flap reconstruction in women with benign, preneoplastic and malignant vulval conditions : a prospective study
Kwong, Fong Lien Pounds, Rachel Farah, Yasmin
Kwong, Fong Lien
Pounds, Rachel
Farah, Yasmin
Abstract
Objectives: To (i) evaluate the surgical morbidity, (ii) identify correlates of these and, (iii) explore whether flap reconstruction following vulvectomy improves patient symptoms and quality of life. Design: Single arm prospective study. Setting: Single tertiary vulval centre, UK. Population: Consecutive cases of women undergoing radical vulvectomy and flap reconstructions for benign and (pre)invasive vulval conditions. Methods: Prospective data collection from April 2020-February 2024. All women were given two validated questionnaires preoperatively and at 3-, 6- and 12-months to evaluate their satisfaction with the aesthetic, genitourinary and psychosexual outcomes. Main outcome measures: Early and late complications within 30 days. Patient reported outcome measures preoperatively and post-reconstruction. Results: 136 flaps in 69 women were analysed. 92.6% (126/136) and 83.1% (113/136) flaps developed none-to-mild complications at 7 days, and between days 8 to 30, respectively. Five necrotic flaps in two patients were surgically debrided. All flaps had healed/healing at 30 days. We did not identify any correlates of complications. At 12 months, women reported an improvement in genital symptoms (p < 0.001). 80.4% (37/46) reported no urinary incontinence vs. 48.1% (26/54) preoperatively, p = 0.0038. 24.4% (11/45) were sexually active vs. 9.3% (5/54) preoperatively, p = 0.0410. More women felt attractive (p = 0.0498), were satisfied with their body (p = 0.0407) and comfortable in intimate situations (p = 0.0273). 88.9% (40/45) stated that reconstruction helped with acceptance of their cancer diagnosis and surgery. Conclusions: Locoregional flap reconstruction has low surgical morbidity, leads to a significant improvement in genitourinary and psychosexual functions. In women with cancer, reconstruction supports women to cope with their diagnosis.
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Date
2025-03-31
Type
Article
Subject
Gynaecology, Oncology. Pathology.
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Citation
Kwong FL, Pounds R, Farah Y, Yap JKW. Vulval Flap Reconstruction in Women With Benign, Preneoplastic and Malignant Vulval Conditions: A Prospective Study. BJOG. 2025 Mar 31. doi: 10.1111/1471-0528.18156. Epub ahead of print
Journal / Source Title
BJOG : an international journal of obstetrics and gynaecology
DOI
PMID
Publisher
Wiley