Vulvectomy

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• Gynaecology
• Vulvectomy

Medically Reviewed October 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

Why might a person require a Vulvectomy?

There are several reasons why a woman may require a vulvectomy:

What are the different types of Vulvectomy surgery?

There are several different types of vulvectomy surgery. How much of the vulva is removed is dependent on the severity of the cancer or health condition and how far it has spread.

• Skinning vulvectomy: This is the least invasive vulvectomy surgery. In a skinning vulvectomy, a surgeon only removes the top layer of the skin, leaving most of the structure of the vulva and surrounding tissue intact. This is commonly used to treat vulvar intraepithelial neoplasia (precancerous cells).
• Simple vulvectomy: In this type of vulvectomy surgery, the entire vulva is removed. This means the inner and outer labia and the tissue just underneath the skin. Sometimes the clitoris is removed too, depending on the patient’s condition.
• Modified radical vulvectomy: Also known as a partial radical vulvectomy, in this surgery most, but not all, of the vulva is removed, along with some of the lymph nodes and surrounding tissue.
• Radical vulvectomy: In a radical vulvectomy, the surgeon removes the entire vulva, including the labia majora, labia minora, clitoris, any other surrounding tissue and lymph nodes.

Some of these procedures involve the removal of large amounts of skin from the vulva. If this is the case, then reconstructive surgery may be required. This involves taking a piece of skin and underlying fatty tissue from one part of the body and using it to reconstruct the vulva. Another option is to have a skin flap, where the surgeon turns an area of skin near the vulva into a flap to cover the wound. However sometimes just stitches are enough if only a smaller amount of tissue has been removed.

What is the recovery time from Vulvectomy surgery?

The recovery time from vulvectomy surgery depends on the extent of the surgery. It usually takes around six to eight weeks to recover.

Following your vulvectomy surgery, you may feel weak and tired for a few days or weeks and may find you need to rest more than usual. You may also experience a brownish discharge - this is normal. You should avoid tight clothing and avoid doing too much walking until the affected skin has healed.

Penetrative sexual intercourse, tampons and swimming should all be avoided for six to eight weeks. You should not drive for at least six weeks, or until you can comfortably perform an emergency stop.

Although vulvectomy stitches are dissolvable they can become tight. If this is the case, they can be removed earlier, depending on how well the wound is healing.

It is crucially important that you keep the wound area clean and dry to help with healing. This will also help to prevent infections.

You should shower the wound area with lukewarm water and dry with a non-shedding cloth or cool hair dryer at least three times a day or after going to the toilet.

It is important to follow all the aftercare advice issued by your surgeon following your vulvectomy. Failure to do so may delay healing and impact upon the final result.

What are the risks and complications of a Vulvectomy?

The risks and complications of a vulvectomy include wound infection, urinary tract infection (UTI) excessive bleeding, scarring, blood blisters, swelling in the legs or groin, blood clots, changes to sexual function, altered sexual pleasure, changes in body image and incontinence. There may be the need for further surgery.