What is a vulvectomy? Purpose, procedure and recovery
June 12, 2025
Medically Reviewed | Last reviewed by on June 12, 2025
The vulva is part of the female genitalia and sits at the opening of the vagina. Sometimes benign or cancerous growths can develop on the vulva. When that happens, a patient may need a vulvectomy to surgically remove those growths.
Here, I¡¯ll share common types of vulvectomies, when they¡¯re used for treatment and what you can expect during and after the procedure.
Reasons for a vulvectomy
Doctors may perform a vulvectomy to treat conditions such as:
- Vulvar intraepithelial neoplasia (VIN) or vulvar dysplasia, a precancerous condition where abnormal cells form on the skin of the vulva. VIN is not cancer, but sometimes it can turn into vulvar cancer.
- Vulvar cancer
Types of vulvectomies
The type of vulvectomy you get will depend on whether the lesion is cancerous, its size and its location.
Your doctor will talk to you about which surgery is right for you.
Simple vulvectomy
A simple vulvectomy is often referred to as a wide local excision. At MD Anderson, we use this procedure to treat precancerous lesions on the vulva. We may also do a simple vulvectomy if you¡¯ve been treated for vulvar cancer and develop a new lesion that we suspect may be cancerous.
During a simple vulvectomy, your doctor will remove the lesion and some of the tissue under the skin. Tumor margin is the healthy tissue bordering the tumor that¡¯s removed during surgery. For a simple vulvectomy, we want to get a tumor margin between 0.5 cm and 1 cm.
Radical partial vulvectomy
A radical partial vulvectomy is used to treat vulvar cancer. During the procedure, the doctor removes the lesion and deeper layers of tissue under the skin. The tumor margin for a radical partial vulvectomy is 2 cm. This margin may be limited due to neighboring structures.
At the time of a vulvectomy, your doctor may also recommend a lymphadenectomy or sentinel lymph node biopsy to remove some of your lymph nodes, depending on where the lesion is and how deep it goes into the vulva.
Preserving function and appearance after surgery
Women often wonder how their vulva will look after a vulvectomy or if their organs will function in the same way.
At MD Anderson, we focus on three things when doing vulvar surgery:
- Margin status
- Function
- Physical appearance
Our goal is to remove the cancer while preserving function and avoiding drastic changes to the vulva¡¯s appearance.
The structures we remove most often during a vulvectomy are parts of the labia minora and labia majora. But if the tumor is close to the clitoris, urethra or anus, we¡¯ll have an honest and informed discussion with the patient about our ability to obtain an appropriate margin.
We¡¯ve evolved from doing radical vulvectomies where we remove most of the vulva, significantly changing its appearance. Surgery is usually not recommended if a tumor is very large, if there are tumors on multiple parts of the vulva, or if a tumor is so close to vital organs that successful surgery would not be possible. In these cases, radiation therapy may be a treatment option.
Vulvectomies do not involve the uterus, cervix, ovaries or fallopian tubes. Since these reproductive organs are not part of the surgery, you can usually still have children after a vulvectomy. Talk to your doctor about your questions regarding fertility and cancer treatment.
What to expect during a vulvectomy
You¡¯ll be given general anesthesia before surgery, so you¡¯ll be asleep and won¡¯t feel any pain. Once you¡¯re asleep, your doctor will use a scalpel to make an incision around the lesion. Then they will cut out the tumor and some surrounding tissue.
Your incisions will be closed together with stitches. If the incision is large, plastic surgeons may perform reconstructive surgery using a tissue flap.
A wide local excision takes about 30 minutes. A radical partial vulvectomy can take 1 to 2 hours. If you get reconstructive surgery, it could take several hours longer.
At the end of the procedure, you¡¯ll get an injection of a local anesthetic to numb the area around the incision to help with soreness. This should last for the first 24 to 48 hours.
You can usually go home the same day after a simple vulvectomy or a radical partial vulvectomy that doesn¡¯t require reconstructive surgery. If you have reconstructive surgery, you may need to stay in the hospital for a few days.
Healing after a vulvectomy
It takes most patients about 4 to 6 weeks to heal after a vulvectomy. During that time, it¡¯s important to keep your incision as dry as possible. Your doctor will give you detailed instructions on aftercare. We often suggest:
- Wearing cotton underwear or no underwear under long dresses or loose-fitting clothes to keep the area aired out and dry
- Running water over the incision during a shower ¨C being sure not to scrub ¨C and patting it completely dry afterward
If you¡¯ve had a simple vulvectomy or radical partial vulvectomy with a small incision, you can usually resume normal activities like walking once you get home.
You should be able to use the bathroom normally.
In about 20% to 30% of cases, there may be a 1 cm to 2 cm opening of the incision. Typically, this opening does not need to be reclosed and will heal on its own by secondary intention healing. This is when the opening naturally heals from the base upward. It¡¯s usually not concerning, but let your doctor know if it happens. They can take a look at it to make sure it¡¯s nothing serious.
If you¡¯ve had reconstructive surgery, you may be given different or more specific instructions about how to care for the incision after surgery.
Managing pain
It¡¯s normal to have some pain near the incision as it heals. Anti-inflammatory medicine should help. See your doctor if you have severe pain. They can prescribe you stronger medicine if it¡¯s needed.
Pain during sexual intercourse is possible after vulvar surgery, depending on the type of vulvectomy and where the tumor was located. You¡¯ll need to refrain from sexual activity for several weeks after surgery. You can resume sexual activity when your doctor says it¡¯s safe to do so.
Side effects
As with any surgery, you may have some side effects after a vulvectomy. Side effects may include:
- Infection
- Soreness near the incision site
- Pain near the incision or during sexual intercourse
Let your doctor know if you are experiencing any side effects after surgery, so they can help you manage them.
Advances in vulvar cancer treatment
Vulvectomies have come a long way over the past several decades. The types of excisional surgeries that were done in the 1960s and 70s are not what we do today. The main reason is because research has shown that they didn¡¯t improve cancer outcomes.
At MD Anderson, we understand the delicate nature of vulvar cancer surgery. That¡¯s why I have thoughtful conversations with my patients about margin status, function and physical appearance before we start treatment. Whether it¡¯s a simple or radical procedure, I want you to feel informed and comfortable with your decision.
, is a gynecologic oncologist at MD Anderson.
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