Vulvectomy

Overview

A vulvectomy is a surgical procedure used to treat or prevent vulvar cancer. During the procedure, your surgeon removes all or part of your vulva.

There are two main types of vulvectomies:

  • Radical vulvectomies — Used to surgically remove the tumor and all surrounding and underlying tissue. Lymph nodes previously identified in a sentinel lymph node mapping will also be removed to evaluate if they are at risk. A plastic surgeon may also be involved in the operation because nearby skin is sometimes used to close the surgical site.
  • Simple vulvectomies — Used to remove superficial tissue in the labia identified as being at risk for vulvar cancer. Women can usually go home the same day of the procedure.

The amount of tissue removed will depend on the size of the tumor, its location and the stage of the cancer. Additional therapy may be needed after the procedure to prevent cancer recurrence.

Vulvar cancer can often spread to nearby lymph nodes. Your physician may recommend a sentinel lymph node biopsy to determine if the disease has spread and will remove any cancerous lymph nodes during the procedure. This procedure occurs on the same day as the vulvectomy.

Reasons for treatment

Vulvectomies are used for women who have or are at risk of vulvar cancer. In most cases, vulvar cancer affects the labia, though the disease can spread to nearby sites, such as the clitoris, vagina or rectum. 

Risks and side effects

The risks for a vulvectomy depend on the type of vulvectomy you receive. Your physician will walk you through all potential risks and side effects before your procedure and answer any questions you may have.

Some common side effects of a vulvectomy include:

  • Pain or discomfort in the surgical area
  • Bleeding and infection
  • Change to the physical appearance of the vulva
  • Stenosis (narrowing) of the vagina
  • Painful intercourse
  • Decreased genital sensitivity 

Treatment preparation

Before your vulvectomy, you will need to undergo a PET/CT scan so your gynecologic oncologist can make sure the cancer is isolated to the vulva. You will also be asked to not eat or drink after midnight the night before your surgery. You also may need to stop taking certain medications.

If you need to take any additional preparation steps, your physician will explain why, what they are and answer any questions you have.

What to expect after treatment

If you have a simple vulvectomy, you will likely be discharged the same day and need no more than three to four weeks to heal. Some soreness around the surgical site is expected. After a follow-up with your gynecologic oncologist, your gynecologist will resume your care.

If you underwent a radical vulvectomy, your gynecologic oncologist will create a treatment plan to reduce the chance of cancer recurrence. In some cases, this is just observation conducted in the office every three to six months. If additional treatment is required, you will likely be referred to a chemotherapy and radiation therapy specialist.

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