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(Skinning Vulvectomy; Partial Vulvectomy; Radical Vulvectomy; Simple Vulvectomy; Vulvectomy—Skinning; Vulvectomy—Partial; Vulvectomy—Radical; Vulvectomy—Simple)

Definition

A vulvectomy is done to remove the vulva or parts of it. The vulva is made up of the genital structures located on the outside of a female’s body. These structures are the clitoris, labia majora, and labia minora.

Reasons for Procedure

This is done to remove cancerous cells from the vulva. It may be able to cure vulvar cancer. It can also be done to remove abnormal skin, like warts.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Bleeding
  • Pain, numbness, or tenderness of the vulva
  • Wound not closing properly
  • Infection
  • Blood clots in the legs
  • Tightness or dryness of the vagina
  • Inability to have an orgasm
  • Chronic leg swelling
  • Reaction to anesthesia

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

What to Expect

Prior to Procedure

Before the surgery, your doctor may:

  • Do a physical exam and review your medical history.
  • Perform blood and imaging tests.
  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.

Before the surgery:

  • Arrange for a ride to and from the hospital.
  • The night before surgery, do not eat or drink after midnight.

Anesthesia

General anesthesia —you will be asleep during the procedure

Description of the Procedure

There are several types of vulvectomy surgery. The type you will have depends on what parts of the vulva and nearby tissue have been affected by cancer or abnormal skin. Examples include:

  • 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, as well as some nearby tissue and lymph nodes
  • Radical vulvectomy—removes the entire vulva, including nearby tissue and lymph nodes

Once all affected areas have been removed, the doctor may need to reconstruct the vulva. If only a small amount of skin was removed, the remaining skin may be able to be stitched together. Sometimes, a skin graft is needed. Temporary drains may be inserted to remove extra fluids from the incision area.

How Long Will It Take?

About 1-2 hours

How Much Will It Hurt?

Anesthesia will prevent pain during the procedure. Pain and discomfort after the procedure can be managed with medications.

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

At the Hospital

Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:

  • Pain medications
  • Antibiotics to prevent infection
  • Medication to prevent blood clots
  • Getting out of bed and walking around

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incisions
At Home

Self-care measures and medications will help ease swelling and pain. Physical and sexual activity may be restricted during this time, but complete rest is not necessary. You may be advised to do exercises to maintain strength and promote healing. To prevent infection at the incision site, follow instructions on how to clean and care for the wound.

Call Your Doctor

Call your doctor if any of these occur:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, tenderness, a lot of bleeding, or discharge from the surgery site
  • Pain, redness, hot skin, or swelling in your legs
  • Burning or pain when urinating
  • Pain that cannot be controlled with the medications you were given
  • Persitent nausea or vomiting
  • Abdominal pain, chest pain, or trouble breathing
  • Surgical wound opens

If you think you have an emergency, call for emergency medical services right away.

RESOURCES

American Cancer Society  https://www.cancer.org 

The American Congress 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

Obstetric and gynecologic surgery. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/La-Pa/Obstetric-and-Gynecologic-Surgery.html. Accessed January 8, 2018.

Treatment option overview. National Cancer Institute website. Available at:https://www.cancer.gov/types/vulvar/patient/vulvar-treatment-pdq#link/%5F49. Updated October 13, 2017. Accessed January 8, 2018.

Vulval cancer surgery. Cancer Research UK website. Available at: http://www.cancerresearchuk.org/about-cancer/vulval-cancer/treatment/surgery. Updated March 16, 2016. Accessed January 8, 2018.

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