Definition
A vulvectomy is surgery to remove the vulva or parts of it. The vulva is the outside part of female genitals. It includes the clitoris, labia majora (outer lips), and labia minora (inner lips).
Reasons for Procedure
This surgery is done to remove cancer cells from the vulva. It can also be done to remove abnormal skin, like warts.
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia
- Infection
- Blood clots
- Tightness or dryness of the vagina
- Not being able to have an orgasm
- Swelling in the legs
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
- Specialists you may need to see
- Tests that will need to be done before surgery
Anesthesia
The doctor will give general anesthesia —you will be asleep
Description of the Procedure
There are several types of vulvectomy surgery. The type depends on what parts of the vulva and nearby tissue have been affected by cancer or abnormal skin. Examples are:
- Skinning vulvectomy—removes the top layer of skin
- Simple vulvectomy—removes multiple layers of skin and tissue
- Partial vulvectomy—removes a part of the vulva, some nearby tissue and lymph nodes
- Radical vulvectomy—removes the entire vulva, including nearby tissue and lymph nodes
Once affected areas are removed, the doctor may need to reconstruct the vulva. Sometimes only a small amount of skin is removed. If so, the remaining skin may be stitched together. Sometimes, a skin graft is needed. Temporary drains may be inserted. The drains remove extra fluids from the incision area.
How Long Will It Take?
About 1 to 2 hours
Will It Hurt?
Anesthesia will prevent pain during the procedure. There will be some pain and discomfort after the procedure. Medicine and home care can help.
Average Hospital Stay
The hospital stay depends on the type of surgery. You may go home the same day or up to a few days after.
Post-procedure Care
After the procedure, the staff may give medicine to:
- Ease pain
- Prevent infection
- Prevent blood clots
During your stay, the hospital staff will take steps to lower your risk of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
It will take a few weeks to recover. Physical and sexual activity may be limited during this time.
Problems to Look Out For
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, a lot of bleeding, or discharge from the site
- Pain, redness, hot skin, or swelling in your legs
- Burning or pain when urinating
- Pain that cannot be controlled with the medicine
- Lasting nausea or vomiting
- Belly pain, chest pain, or trouble breathing
- New or worsening symptoms
If you think you have an emergency, call for medical help right away.
RESOURCES
American Cancer Society https://www.cancer.org
The American College of Obstetricians and Gynecologists https://www.acog.org
CANADIAN RESOURCES
Canadian Cancer Society https://www.cancer.ca
Women's Health Matters—Women's College Hospital http://www.womenshealthmatters.ca
References
He L, Chen G, et al. Safety and feasibility of single-incision radical vulvectomy: a novel approach for the treatment of vulvar cancer. Ann Transl Med. 2021;9(4):320.
Obstetric and gynecologic surgery. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/La-Pa/Obstetric-and-Gynecologic-Surgery.html. Accessed April 1, 2022.
Vulval cancer surgery. Cancer Research UK website. Available at: http://www.cancerresearchuk.org/about-cancer/vulval-cancer/treatment/surgery. Accessed April 1, 2022.
Vulvar cancer treatment. National Cancer Institute website. Available at: https://www.cancer.gov/types/vulvar/patient/vulvar-treatment-pdq#link/%5F49. Accessed April 1, 2022.
Vulvar intraepithelial neoplasia (VIN). https://www.dynamed.com/condition/vulvar-intraepithelial-neoplasia-vin. Accessed April 1, 2022.
Revision Information
- Reviewer: EBSCO Medical Review Board Nicole Meregian, PA
- Update Date: 04/01/2022