Medical Oncologist
CION Cancer Clinics
Groin node surgery with a vulvectomy | CION Cancer Clinics
Groin node dissection removes the lymph nodes in one or both groins, because vulval cancer that spreads usually reaches them first. It is done in the same operation as the vulvectomy, through a separate cut in the groin crease. The nodes are examined under a microscope, and the result decides whether radiotherapy is needed afterwards. This page explains the options, the recovery, the side effects such as leg swelling, and what to ask. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Why are the groin lymph nodes removed with a vulvectomy?
- Three ways the groin can be dealt with
- What recovery from groin surgery usually looks like
- What can go wrong after groin node surgery?
- Words you will see, in plain language
- Four things families tell us, and what is actually true
- What this page cannot tell you, and what to ask
- Common questions about groin node surgery for vulval cancer
The short answer
Why are the groin lymph nodes removed with a vulvectomy?
Vulval cancer, when it spreads, goes first to the lymph nodes in the groin. Removing them, or checking them, tells the team whether the cancer has travelled, and removes any cancer that has. It is done in the same operation as the vulvectomy, through a separate cut in one or both groin creases.
Why it matters for what comes next
A scan cannot reliably show small amounts of cancer inside a node. Only the pathologist, looking at the node under a microscope, can. If the nodes are clear, surgery alone is usually enough. If a node contains cancer, radiotherapy to the groin is usually advised afterwards. The groin surgery is how that decision is made.
Who does not need it
Groin surgery is usually not needed for pre-cancer (VIN), or when the cancer has grown only a very short distance into the skin on the biopsy, because the chance of spread is then very small. It may also be left out when a person is not fit for a longer operation, and radiotherapy to the groin is used instead.
The options
Three ways the groin can be dealt with
The choice depends on the size of the cancer, where it sits and whether the nodes feel or look enlarged.
Sentinel node biopsy
Only the first one or few nodes that the vulva drains to are found and removed. If they are clear, the rest are left in place. It is a smaller operation with fewer long-term effects.
Usually suits
- A small single cancer
- Nodes that feel and look normal
Full groin node dissection
The whole group of nodes and the fat around them is removed from one or both groins. The report on the file may call it inguinofemoral lymphadenectomy, which means the same thing.
Usually suits
- Larger cancers, or more than one
- A sentinel node found to contain cancer
- Nodes that already look enlarged
One groin or both
A cancer clearly on one side usually drains to that groin, so only that side is operated on. A cancer near the middle, close to the clitoris or the perineum, can drain to either side, so both groins are checked.
If one side shows cancer, the other side is often treated too.Not sure whether this applies to you?
Ask an oncologistAfter the operation
What recovery from groin surgery usually looks like
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Waking up with drains
A thin drain tube usually comes out of each operated groin, taking away fluid that collects where the nodes were. Walking gently, with help, starts early to protect against clots.
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The drains come out
When the fluid slows, the drain is removed. Some women go home with a drain still in, and a nurse or the ward shows the family how to empty and record it.
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Fluid after the drain is out
A soft swelling in the groin, called a seroma, is common. Small ones settle on their own. A large or tight one is drained with a needle in clinic.
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The pathology report
The report says how many nodes were removed and whether any contained cancer. This decides whether radiotherapy is recommended, and it is the appointment to bring the family to.
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Watching the legs
Leg swelling can appear months or even years later. Knowing the early signs, and who to tell, matters more than anything done in the first weeks.
Side effects
What can go wrong after groin node surgery?
Groin wounds heal more slowly than most, because they sit in a fold of skin that bends every time you sit or walk. A full node dissection has noticeably more side effects than a sentinel node biopsy, which is the main reason the smaller operation is used whenever it is safe.
Wound problems
The wound can open partly, or become infected. This is common enough after a full dissection that the team plans for it. An open wound usually heals from the bottom up with regular dressings, which can take several weeks and may continue at home.
Leg swelling (lymphoedema)
With the nodes gone, fluid from the leg drains less well, and the leg can swell. It is much more likely after a full dissection, and after radiotherapy to the groin as well. It can often be controlled with stockings, skin care and massage when it is caught early.
Numbness on the front of the thigh
Small skin nerves run through the groin fat. A patch of numbness on the upper thigh is common and usually lasts, though it rarely gets in the way of daily life.
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On your report
Words you will see, in plain language
- Inguinofemoral nodes
- The lymph nodes in the groin crease and just below it at the top of the thigh.
- Lymph node
- A small bean-shaped gland that filters fluid. Cancer that spreads from the vulva usually reaches these first.
- Positive or negative node
- Positive means cancer was found in the node. Negative means none was found.
- Extracapsular spread
- Cancer that has broken through the outer wall of a node. It usually makes radiotherapy afterwards more likely.
- Seroma
- A pocket of clear fluid that collects where the nodes were removed.
- Unilateral or bilateral
- One groin or both groins.
Commonly believed
Four things families tell us, and what is actually true
"If the scan showed nothing in the groin, the surgery is not needed."
A scan can miss small amounts of cancer inside a node that looks normal in size. That is why the nodes are checked surgically for most cancers deeper than a thin surface layer, even when the scan is clear.
"Removing all the nodes is safer than a sentinel node."
For a small cancer with normal-feeling nodes, a sentinel node biopsy finds spread reliably and causes far less leg swelling and fewer wound problems. A full dissection is kept for when it is actually needed.
"Without the nodes, her immunity will be gone."
The body has hundreds of lymph nodes, and removing the groin group does not leave you unable to fight infection in general. It does make the leg on that side slower to clear fluid and infection, which is why skin care on that leg matters.
"Leg swelling means the cancer is back."
Usually it means fluid is draining slowly because the nodes are gone. It still needs to be seen, because new swelling can occasionally have another cause, but it is far more often the side effect than the cancer.
Being straight with you
What this page cannot tell you, and what to ask
This page cannot tell you whether your groins need surgery, or which kind. That depends on your biopsy depth, the size and position of the cancer, a scan and an examination, and the decision is made with your treating team. It also cannot tell you whether your nodes will contain cancer; only the pathology report can.
Questions worth asking
Will one groin or both be operated on, and why. Is a sentinel node biopsy possible for me, and if not, why not. Will I go home with a drain. Who will see my leg if it swells, and when should I call. Would radiotherapy to the groin be an alternative in my case.
Questions we are asked
Common questions about groin node surgery for vulval cancer
Is groin node surgery a separate operation?
Usually not. It is done under the same anaesthetic as the vulvectomy, through its own cut in each groin crease. If a sentinel node is found to contain cancer after the first operation, a second operation to clear that groin is sometimes needed, or radiotherapy is used instead.
How many nodes are removed?
It varies from person to person, because people have different numbers of groin nodes. A sentinel biopsy removes only one or a few. A full dissection removes the whole group. Your report will list the count, and the pathologist and surgeon will explain what it means for you.
Will I go home with a drain?
Some women do, particularly after a full dissection, because fluid can keep coming for a while. The ward will show whoever is caring for you how to empty it and write down the amount. A nurse or clinic removes it once the fluid slows.
Can I sit and walk normally afterwards?
Walking gently is encouraged from early on. Long sitting and deep bending pull on the groin wound, so short spells are better at first. Avoid heavy lifting until your surgeon says the wound is strong enough. Most women build back to normal activity gradually.
What can I do to lower the chance of leg swelling?
Look after the skin of that leg, treat cuts and insect bites promptly, stay active and keep to a healthy weight. Tell the team early if the leg feels heavy or tight. Nothing removes the risk entirely, but early treatment makes swelling much easier to control.
Why is radiotherapy needed if the nodes were removed?
When cancer is found in a node, or has broken through its wall, small amounts may remain in the groin tissue even after the nodes are out. Radiotherapy treats that area. It is advised on the basis of the report, and your team will explain the reasons for your own case.
Is keyhole surgery possible for the groin?
Some centres remove groin nodes through small cuts with a camera, and a few studies suggest fewer wound problems. It is not yet standard everywhere. Ask your centre which method they use, and what their experience with it is.
Is groin node surgery covered by Aarogyasri or insurance?
Usually yes, as part of the same approved cancer surgery. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Call the helpline with your card details and we will check your cover before admission.
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Sources
- Cancer Research UK — Surgery for vulval cancer
- American Cancer Society — Surgery for vulvar cancer
- National Cancer Institute — Vulvar Cancer Treatment (PDQ) - Patient Version
- Macmillan Cancer Support — Vulval cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Sentinel Node Biopsy for Vulvar CancerThe smaller groin operation, and who it suitsLeg Lymphoedema After Vulvar Cancer SurgerySpotting and controlling leg swelling earlyWound Healing in the Groin and PerineumWhy groin wounds are slow, and how they are cared forDrains, Tubes, Lines and CathetersLooking after a drain at homeThe Pathology Report After SurgeryReading the node count and what it means
Talk to us
Told your groin nodes need surgery?
Send us the biopsy report and any scans, or call the helpline. A surgical oncologist will explain whether a sentinel node or a full dissection is being planned, and why. One helpline serves every CION centre.