Vulvectomy as a Gynecological Procedure and What it Means to YOU

Added: 02/03/2006

I usually play things up for laughs, but not this time. Not when the topic is vulvectomy. Vulvectomy is gynecological procedure involving partial or complete removal of vulva. Normally it is performed as a last stage of cancer. Depending upon the extent of cancer, its size and localization, two types of vulvectomy are distinguished: simple, partial and radical. The preferred type of treatment is surgery. Here is given the description of the procedure, side effects and post operational difficulties.

As known, cancer is uncontrolled growth of cells. Cancer of the vulva starts at the skin of the vulva. Typical symptoms are lumps or sores on the vulva, itchiness. Usually this type of cancer spreads to the lymph nodes in the groin which are responsible fro draining fluid from the body. Among the factors that increase the risk of vulva cancer smoking occupies one of the first places.

Depending upon the extent of cancer, simple and partial vulvectomy or radical vulvectomy is performed. Simple vulvectomy presupposes removal of the cancer (or abnormal skin) and home healthy tissue around it. Simple vulvectomy is characterized by fewer side effects and aggravations. Partial vulvectomy means removing part of the vulva. Radical vulvectomy means removal of all or most of the vulva. The surgeon removes lymph nodes on one or both sides of the groin. Patient has to carry drains and Foley catheter to drain urine some days after the performed surgery.

To get prepared to surgery a patient has to undergo a number of tests: blood and urine test, chest X-Ray, electrocardiogram (for patients over 50). After examination the surgeon appoints you an operation.

After performed vulvectomy the patient should stay in bed for some days after the surgery to let the incision heal. Often turning over is recommended to avoid pneumonia. Sometimes patients use pain-killers to reduce pain when walking which helps blood circulation and muscular system. To prevent infection patients are strongly advised to keep incision clean and dry. Nurses usually instruct patients on such matters.

Sometimes advanced vulva cancer spreads to other areas. In such cases, the surgeon will have to remove one or more of the following: lymph nodes, the lower part of the bowel, back passage, bladder, womb, and vagina.

Sometimes other kinds of treatment are necessary alongside with vulvectomy. These kinds of treatment may precede or follow the surgery. Before the surgery you may have to undergo neo-adjuvant treatment. This procedure will shrink the cancer and make it easier to remove. It will enable you to have a smaller operation. After the surgery you may have to undergo adjuvant treatment. This may be radiotherapy that will kill the remaining abnormal cancerous cells and will decrease the risk of cancer coming back again.

After the vulvectomy, the patient may have a number of side effects. These are the risk of infection at the surgery area or opening of the incision. It may also be urine infection, thrombosis, i.e. blood clot in the patient's leg. To prevent thrombosis a patient has to move his legs while staying in bed. As with almost all kinds of surgery there is a little risk of bleeding at the surgery area.

Vulvectomy is also associated with some sexual difficulties. Sexual activity can be resumed 6-8 weeks after surgery when incisions are completely healed. Sexual difficulties include numbness or tenderness, shortened vagina, dryness of vagina, decrease in sensation in the perineum. To avoid these problems, patients are advised to try different positions when making love, special gels will reduce vaginal dryness.

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