A vulvectomy is a procedure where a surgeon removes all or part of the vulva — the vulva includes the inner and outer labia. In some instances, a surgeon will also remove the clitoris.
The purpose of the procedure is to remove cancerous, precancerous, or other unhealthy tissue.
This article will outline what a person should expect from surgery, the length of the healing process, and outlook.
When a surgeon performs a vulvectomy they partially or fully remove the vulva, which is the outer portion of a female’s genitals.
The vulva includes:
- labia minora
- urethral meatus
- labia majora
- certain glands and ducts
A vulvectomy is the main treatment for vulvar cancer. How much of the vulva a surgeon removes depends on the severity of cancer or other health condition.
A doctor may perform a vulvectomy to:
- remove precancerous or cancerous cells
- remove skin cancer
- treat severe skin diseases, such as lichen sclerosus
- treat severe sweat gland diseases
The term vulvectomy covers several different surgical procedures. They include:
- Skinning vulvectomy: A surgeon removes the top layer of skin, leaving most of the structure and other tissue intact.
- Simple vulvectomy. A surgeon removes the entire vulva, except for the clitoris (in most cases).
- Modified radical vulvectomy. A surgeon removes most but not all of the vulva, some of the lymph nodes, and surrounding tissue.
- Radical vulvectomy. A surgeon removes the entire vulva, surrounding tissue, and lymph nodes.
The type of surgery a person needs depends on the severity of their cancer or other underlying health condition.
The Memorial Sloan Kettering Cancer Center recommends people stop smoking and drinking once they know their surgery date.
Prior to surgery, a person should also speak with their doctor about the following:
- use of recreational drugs
- presence of sleep apnea
- use of herbal or natural supplements
- use of a pacemaker or other internal devices
- allergies or reactions to medications, including anesthesia
- use of over-the-counter or prescription medications
- use of blood thinners
The surgery consultation gives a person the opportunity to ask questions about the procedure and aftercare. The surgeon will advise on how to prepare for surgery, for example, by taking or avoiding certain medications.
The surgeon makes one or more incisions on the vulva before removing the tumor or area of concern and surrounding tissue. Depending on the severity of cancer, they may also remove some or all of the lymph nodes in the groin. Reconstruction of the vulva may happen directly after vulvectomy.
After the procedure, doctors and nurses will monitor a person’s progress in the recovery room. Some people may need to stay in hospital for a few days to recover. Before a person goes home, a healthcare team will discuss aftercare with them.
When recovering at home, a person may find the following items useful:
- clean, soft towels to pat dry the area
- squirt bottles and supplies for a sitz bath to help clean the area
- hair dryer with a cool setting to dry the area
- cotton underwear
- loose-fitting clothing
- thermometer for checking for fever
While at home, people should also keep on top of their medication and pain relief, as this will aid their recovery and help them feel more comfortable.
In the first few days after surgery, a person may need to stay in bed and need extra help with changing dressings, so family and friends should help out as much as they can.
Complications and risks of a vulvectomy include:
It can take several weeks for a person to fully recover from a vulvectomy. A person should keep all follow-up appointments with their doctor and follow all home care advice to aid recovery.
When a surgeon removes part or all of the vulva, the procedure is known as a vulvectomy. The aim of the surgery is to remove cancerous or unhealthy tissue in the vulva area.
Recovery time varies between individuals and may take several weeks. If the stitches are taking longer to heal than expected a person should contact their doctor or aftercare team. A person should also contact their doctor if there are any signs of infection or any new or worsening symptoms.