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Treatment | Vulvectomy, vulvar excision surgery

These FAQs have been answered by women who have had surgery for cancer of the vulva. For more information, please visit our Web Resources section "Treatments and Tests" and Our Stories by survivors of vulvar cancer.

 What will help with healing after a wide local excision of the vulva?

 What advice do you have for recovery after a radical vulvectomy?

 

 I had a wide local excision of the vulva. What will help with healing this area?

 Holly, Maryland, USA: Here are some things that can help with the healing and just generally make you feel more comfortable after the surgery:

1. Make sure you have sitz baths both at the hospital and at home. Besides being really soothing after the surgery, they also aid with healing by helping to keep the vulva clean.

2. Make sure to rinse the vulva after you use the bathroom and then be sure it is as dry as possible, perhaps by using the cool setting on a blow dryer.

3. Don't be afraid to ask for pain medication and ask for more if you are still having pain.

4. A ring pillow (the kind for hemorrhoids) is really helpful for sitting, as you can sit without anything touching the vulval area.

5. There is a lidocaine spray or cream to put on the area, which helps with pain relief.

Mostly it's just a matter of taking frequent sitz baths and keeping the vulva as clean and dry as possible. I went without underwear at first and would sit and try to keep my legs open so the area would stay drier (not the position you normally want to be in, but the doctors told me that I seemed to heal quickly from this surgery, so I think it must have helped).

After the initial four to six week period, what I noticed for the next several months was occasional periods of pain. At first areas may seem numb, but when the nerves rebuild you may get tingling or pain (not pain enough to need pain medications).

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 Deborah, Florida, USA: An ice pack that looks like a big sanitary pad was given to me in the hospital and was very helpful. I used it almost continuously for the first two days to help relieve the pain and keep the swelling down. You will probably experience some bleeding for a few days which will require you to wear a pad. See if you can find one of those old sanitary belts, as wearing underwear will be too painful.

You will need a bowl or water bottle to clean the vulval area after using the bathroom and will need to blow dry the area on a cool setting when you are done. It will also help to have a hand-held shower head for cleaning the area.

Don't plan on being able to sit straight for a few weeks - a reclining position in which you don't actually sit on the vulva will help. I put my bed right next to my computer so I could recline and reach it from my bed comfortably.

Have some long skirts or dresses handy, as you will not be able to wear underwear and will need to get air to the vulval area. I was also told not to walk much, as it would cause pain, and it did! But I was also told not to lay around all the time as that can cause blood clots. You probably won't feel like doing much anyway.

Because of the pain medications, I slept most of the first week. My doctor told me that healing is difficult in the vulvar area, and to be careful. However I healed fine, so it's not always the case. Everyone is different, but I didn't find it to be as painful as I expected.

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 What advice do you have for recovery after a radical vulvectomy?

 Carol J., UK: I had squamous cell carcinoma of the vulva, and had to have a radical vulvectomy and complete node excision. My surgery also included a clitorectomy. Not all ladies are made aware that they will lose their clitoris with this surgery; I feel that this is a very important factor with the surgery - it's less of a shock if they are prepared for it beforehand.

First of all, make a list of your questions to take along to your next doctor's appointment. When you get in there, your mind will just not function very well - so get making that list!

To be honest, I had a lot of pain after my surgery. Try to take your pain medication regularly in order to keep the pain under control. Getting plenty of rest is very important, as is a good diet. I also took vitamins to help boost my immune system.

My doctor recommended absolutely no exercise for the first couple of weeks, and I took just a few steps to keep everything from cramping. Later on, I walked in our garden in my nightgown, which was most comfortable for me. Also, make sure your slippers are a slip-on style with non-slip soles, as you will be too sore to bend over and surely don't want to slip and fall.

Wearing underwear will not be an option at first, as they put special ones on you after surgery to help hold on your dressings. When you get home, you will need 100% cotton underpants, as nylon is out of the question because the nylon will make you sweat and lead to a possible yeast infection. A good tip is to wear your underwear inside out so that the seams, which can be quite hard, will not rub on you and cause you discomfort. Also, you won't want to wear trousers for a while. I found wearing cotton jogging bottoms very comfortable because they are loose fitting and don't hurt you. If you do want to wear a skirt and tights, cut the nylon gusset out of the tights.

Having plenty of baths is great, using only water - no oils or bubble baths. Soap is not allowed near the surgical area at all. Sitting in the bathtub was very uncomfortable, so I would take a large towel, fold it and place it in the bottom of the tub to sit on. This was very helpful.

You will not be able to use creams immediately after surgery, but as time goes on, the surgical site may feel quite tight, and finding the right cream to suit you may be difficult.

Sterile gauze pads, like the ones the hospital used for dressing your surgical site are very good to use for wiping after going to the bathroom. You will probably be too swollen and sore the first four weeks, but these thin pads come in handy later on. I still use them and even carry them in my purse.

For bedtime, have a spare pillow available and put it between your knees. My knees ached terribly afterwards and I found this to be very comfortable.

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