A vulvectomy is a surgical procedure performed to remove a woman’s vulva.
A vulvectomy is a surgical procedure in which all or part of the vulva, the outer part of the female genitalia, is removed. Women diagnosed with vulvar cancer may require surgery to remove the cancer cells. Typically, patients will undergo radiation or chemotherapy before surgery to shrink the tumor and reduce the need for extensive surgery.
The risk of urinary tract infections is much higher after a vulvectomy.
There are several different types of vulvectomies, and which one is used depends on the size of the cancerous area, how advanced the cancer is, and how far it has spread. Only the top layer of skin is removed in a spherical vulvectomy. Although it is the least invasive procedure, skin-removing vulvectomies are rarely done because of the increased risk of leaving cancerous cells in the vulva.
Radical vulvectomies involve removing the entire vulva, including the clitoris.
A simple vulvectomy involves the complete removal of the vulva. This procedure is commonly performed in patients with non-invasive vulvar cancer. If the cancer has not spread to the lymph nodes or surrounding tissues, a simple vulvectomy provides reassurance that all or most of the cancerous cells and tissues have been removed.
Radical vulvectomies can be total or partial in nature. Partial vulvectomies include removing part of the vulva, including the deep tissue. A complete or complete radical vulvectomy is the most invasive vulvectomy procedure. It involves removing the entire vulva, including the deep tissues and the clitoris. Complete radical vulvectomy procedures are only done on more advanced types of vulvar cancer, and a separate procedure to remove the groin lymph nodes may be done if the cancer has spread.
As with any surgical procedure, vulvectomies have associated risks and potential complications.
Reconstructive surgery is usually necessary for women who have had a vulvectomy. Skin vulvectomies and some partial vulvectomy procedures may not need any reconstructive surgery, as these wounds often heal on their own. Skin grafts are often needed for more extensive procedures. Sometimes fatty tissue is removed from another area of the body along with the skin graft to replace the natural “filler” of the vulva.
Side effects of vulvar surgery can include discomfort during sex.
As with any surgical procedure, vulvectomies have some associated risks and possible complications. Women often complain of discomfort when wearing tights or riding a bicycle due to the lack of fatty tissue to protect the urethra and vaginal opening. Many women are uncomfortable with the change in appearance of the vulva after surgery. When a large amount of skin and tissue is removed, the risk of infection or failure of a skin graft increases.
Lymph nodes in the groin may need to be removed if vulvar cancer has spread.
Rarely, serious complications can occur after vulvar surgery. Fluid-filled cysts can form near the wounds and blood clots can form and travel to the legs and cause serious circulatory problems. The risk of urinary tract infections is much higher after vulvectomy due to increased exposure of the urethra. Many women also experience sexual side effects, including inability to reach orgasm or pain and discomfort during sex.