What is vulvectomy?

ichhori team

What Is Vulvectomy?

A vulvectomy is a surgical procedure that involves removing part or all of the vulva—the outer portion of the female genitalia. Though not commonly performed, it is often necessary to treat or prevent conditions like vulvar cancer or chronic skin disorders such as lichen sclerosus that are unresponsive to non-surgical treatments.

Understanding what a vulvectomy entails, why it's performed, and how it affects physical and emotional health can help women facing this surgery feel more informed and empowered.

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Learn what a vulvectomy is, when it's needed, the different types of procedures, side effects, recovery process, and impact on women’s health and intimacy.

Why Is Vulvectomy Performed?

A vulvectomy may be recommended to treat or prevent the following conditions:

  • Vulvar cancer – The most common reason, especially if the cancer is invasive.
  • High-grade vulvar intraepithelial neoplasia (VIN) – Precancerous changes to the vulva.
  • Lichen sclerosus – A painful chronic skin condition.
  • Recurrent HPV-related lesions – Such as genital warts that have become resistant to treatment.

In all cases, the goal is to remove diseased tissue while preserving as much healthy tissue and function as possible.

Types of Vulvectomy Procedures

The type of vulvectomy performed depends on the severity and extent of the condition:

1. Simple Vulvectomy

Removal of the entire vulva without affecting deeper structures like lymph nodes.

2. Radical Vulvectomy

Removal of the vulva along with nearby tissues and lymph nodes, often used in advanced cancer cases.

3. Partial Vulvectomy

Only part of the vulva is removed, typically for smaller lesions or early-stage disease.

4. Skinning Vulvectomy

Only the top layers of vulvar skin are removed; healthy tissues underneath are preserved.

What to Expect Before and During the Procedure

  • The procedure is done under general anaesthesia.
  • It can last 1–3 hours depending on the extent of tissue removal.
  • Reconstructive surgery may be done simultaneously to improve comfort and appearance.
  • A hospital stay of 1–5 days may be required, especially after a radical vulvectomy.

Post-Surgery Recovery and Care

Recovery can take several weeks. During healing:

  • Swelling, bruising, and tenderness are common.
  • Pain management, antibiotics, and rest are important.
  • Sexual activity, heavy lifting, and baths should be avoided for 4–6 weeks.
  • Urination and bowel movements may be uncomfortable initially.

Full recovery takes 6–8 weeks. Emotional support is also essential during this time.

Potential Side Effects and Risks

  • Infection or poor wound healing
  • Bleeding or blood clots
  • Scarring and disfigurement
  • Numbness or nerve pain in the genital area
  • Body image concerns and intimacy issues

Impact on Sexual Health

A vulvectomy can affect sexual sensation, desire, and confidence. Some women experience:

  • Loss of sensitivity depending on what tissues are removed
  • Vaginal dryness or pain during sex
  • Reduced interest in sexual activity due to psychological effects

Options like pelvic floor therapy, lubricants, and sex therapy can aid in recovery and renewed intimacy.

Also read: Why May Women Experience Sexual Dysfunctions During or After Pregnancy?

Emotional and Psychological Support

Many women experience anxiety, depression, or grief after a vulvectomy. It's important to seek:

  • Professional mental health support
  • Peer support groups or communities
  • Family and partner communication

Recovery involves healing both the body and the mind.

Follow-Up Care

  • Regular follow-ups with your gynaecologist or oncologist are crucial.
  • Additional treatment such as radiation may be recommended if cancer is found in lymph nodes.
  • Any unusual bleeding, swelling, or fever after surgery should be reported promptly.

Life After Vulvectomy

Many women return to normal daily activities after recovery. Intimacy, self-confidence, and quality of life can improve over time with support and proper guidance. Advances in reconstructive techniques and psychological therapy continue to offer hope and healing.

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Conclusion

A vulvectomy is a medically necessary procedure that can be life-saving in cases of cancer or severe disease. While the physical and emotional impacts are significant, early intervention, emotional support, and holistic post-operative care can help women recover with strength and dignity. Education, awareness, and empathy make a world of difference for those going through this journey.

FAQs

Q. Can you have sex after a vulvectomy?

Yes, but it depends on the type of procedure. Intimacy may require time, therapy, and emotional support.

Q. Is vulvectomy only done for cancer?

No. It may also be performed for conditions like VIN or lichen sclerosus that don’t respond to non-surgical treatments.

Q. How long does it take to heal after vulvectomy?

Physical healing usually takes 4–8 weeks. Emotional healing varies but can be supported with therapy and community.

Q. Will the vulva grow back after removal?

No. Once removed, vulvar tissue does not regenerate. In some cases, reconstructive surgery may be done to restore appearance.

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