Impaired body image and physical and sexual limitations after surgical therapy for vulvar cancer: a qualitative study

Purpose: Surgical treatment for vulvar cancer has impact on women’s self-esteem, body image and sexuality. Health Care Professionals experience difficulties in discussing these issues with patients. The aim of this study was to explore the experiences of patients with vulvar cancer regarding sexual changes, and their needs and expectations regarding sexual counseling. Methods Individual semi-structured interviews were conducted with patients who were surgically treated for vulvar cancer. All interviews were transcribed verbatim and thematically analyzed. Results Seven patients (mean age 54, 86% stage 1B vulvar cancer) participated. Seven themes were identified and were linked to the biopsychosocial framework: 1) the impact of physical disabilities on body image, 2) sexual dysfunction, 3) grieving the loss of sexual health, 4) ambivalence in the acceptance of sexual changes, 5) the effect of the partner on sexual experience, 6) the attitude of the Health Care Professional (HCP), and 7) discussing sexuality: the right moment Conclusion Patients who are surgically treated for vulvar cancer experience problems related to impairment on daily activities, altered body image and sexuality. Especially difficulties in reaching an orgasm or anorgasmia are hard to accept. Both the partner and HCP play an important role in how patients experience discussing and exploring sexuality after treatment. Since informational needs regarding sexuality change over time and patients start to fantasize about sex after 4–6 months, it is recommended to schedule an appointment 4–6 months after surgery to discuss patients’ needs regarding sexual information and counseling.