Medical Oncologist
CION Cancer Clinics
Passing urine after a vulvectomy | CION Cancer Clinics
After a vulvectomy, urine often sprays or goes sideways because the skin folds that guided the stream have been removed or reshaped. It usually stings on the healing wound too. This is common and rarely a sign of a problem. This page explains why it happens, what the catheter involves, simple ways to manage at home, and the signs that need same-day care. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Why does urine spray after a vulvectomy?
- What happens with the catheter and the first days?
- What helps the stream go where you want it?
- What do women worry about that is not true?
- Who finds this harder, and what can this page not tell you?
- What do the nurses mean when they say these words?
- Common questions about passing urine after a vulvectomy
The short answer
Why does urine spray after a vulvectomy?
Urine often sprays or goes sideways after a vulvectomy because the skin folds that used to guide the stream have been removed or reshaped. It is very common, it is not a sign that something has gone wrong, and simple changes to how you sit and wash usually make it manageable.
What has changed down there
The opening you pass urine from, called the urethra, sits just in front of the vagina. The inner and outer lips of the vulva normally sit on either side of it and act like a channel. When some or all of that tissue is taken away, the stream has nothing to guide it. Swelling and stitches near the opening can also push the flow off to one side in the early weeks.
Why it stings
Urine touching a raw or healing wound stings. This is a surface sting on the skin, not a burning deep inside, and it usually eases as the wound closes. Rinsing with water while you pass urine helps a great deal.
Does it stay like this?
For many women the spray settles once the swelling goes down. For some, especially after a larger operation, the stream stays a little unpredictable for good, and most find a routine that works.
In hospital and after
What happens with the catheter and the first days?
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A catheter goes in during the operation
A thin tube, called a catheter, is passed into the bladder while you are asleep. It drains urine into a bag so the wound stays dry and clean in the first days, when it is most delicate.
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The catheter stays for a few days
How long depends on the size of the operation and how close the wound is to the urethra. Some women go home with the catheter still in and return to have it taken out. The nurses will show you and your family how to empty and care for the bag.
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The catheter comes out
Removing it takes a few seconds and feels odd rather than sore. You will be asked to drink normally and tell the nurse when you first pass urine. The team may check that your bladder is emptying fully, sometimes with a quick ultrasound over the tummy.
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The first few times on the toilet
Expect some stinging, a stream that goes in an unexpected direction, and a feeling of wanting to go more often. Take a jug of warm water with you from the very first time.
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The weeks at home
The sting usually fades as the skin heals. The direction of the stream often improves as swelling settles. Tell your team at follow-up if it has not, because a continence physiotherapist can help.
Not sure whether this applies to you?
Ask an oncologistPractical help
What helps the stream go where you want it?
None of these needs special equipment. Try them one at a time and keep the ones that work for you.
Change how you sit
Sit well back on a Western-style toilet and lean forward slightly. Some women find leaning back works better. Moving a little while you go often changes the angle enough.
An Indian-style squat toilet is hard on a fresh wound. A commode chair or raised seat helps in the early weeks.Rinse as you go
Pour warm water slowly over the front of the vulva from a jug or mug while you pass urine. It dilutes the urine, washes it off the wound and takes most of the sting away.
If you use a health faucet
- Keep the pressure low
- Use lukewarm, not hot, water
- Aim from front to back
Guide the flow
Holding a folded wad of soft toilet paper just in front of the opening can direct the stream downward. Some women use a clean, soft cloth kept only for this.
Pat, never rub
Dry the area by gently patting with a soft, clean towel. Rubbing drags at stitches and irritates healing skin. Change into loose cotton underwear after drying.
!
When passing urine needs same-day care
If you cannot pass urine at all and your lower tummy feels full and painful, contact your surgical team or go to the nearest emergency department the same day. Do the same if a burning feeling inside comes with fever, shivering, or cloudy, strong-smelling urine. Do not cut down on water to avoid going. That makes the sting worse and hides the problem.
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Commonly believed
What do women worry about that is not true?
"If I drink less, it will sting less."
The opposite is true. Less water makes urine stronger, and strong urine stings more on a wound. It also raises the chance of a urine infection. Keep drinking normally unless your doctor has told you to limit fluids for another reason.
"Spraying means the operation went wrong."
It means the tissue that guided the stream is no longer there, which was part of removing the cancer safely. It is an expected change, not a mistake, and it is one of the most common things women mention at follow-up.
"Urine on the wound will make it infected."
Fresh urine is not dirty in the way people fear. What matters is rinsing it off and keeping the area dry afterwards. Wounds in this area heal slowly for other reasons, and your nurse will check for infection at each visit.
"I will have to wear a pad for the rest of my life."
Most women do not. Some notice a little leaking when they cough or lift, especially if part of the urethra was removed. Pelvic floor exercises help many of them, and a continence physiotherapist can teach these properly.
Being straight with you
Who finds this harder, and what can this page not tell you?
Some women have a harder time than others. The spray and leaking tend to be more noticeable after a radical vulvectomy, where more tissue is removed, than after a small wide local excision. Women who already had bladder weakness before surgery, often after childbirth or with age, may find it worsens for a while.
If the wound opens near the urethra
Wounds in this area sometimes open partly before they heal. If that happens close to the opening, urine may sting for longer and your nurse may suggest a barrier cream. It usually still heals with time.
What this page cannot tell you
It cannot tell you exactly how your stream will behave, because that depends on how much tissue was removed and where. It cannot tell you whether your urethra was involved. Only your operation note and your surgeon can. Ask at your follow-up visit, and bring the question written down if it feels awkward to say aloud.
Words you may hear
What do the nurses mean when they say these words?
- Urethra
- The short tube that carries urine from the bladder to the outside. Its opening sits just in front of the vagina.
- Catheter
- A thin, soft tube passed into the bladder to drain urine into a bag while the wound heals.
- Residual urine
- Urine left in the bladder after you have been. Nurses check this to make sure the bladder is emptying properly.
- Stress incontinence
- Leaking a little urine when you cough, sneeze, laugh or lift something.
- Urine infection
- Germs growing in the bladder. It causes burning inside, a need to go often, and sometimes fever.
Questions we are asked
Common questions about passing urine after a vulvectomy
Why does my urine spray everywhere after vulval surgery?
The lips of the vulva normally guide the stream, and some or all of them were removed. Swelling near the opening can also push the flow sideways. Sitting further back, leaning forward, and holding soft toilet paper in front of the opening usually help. Many women notice it improves as the swelling settles.
How do I stop the stinging when I pass urine?
Pour warm water slowly over the front of the vulva while you go, then pat dry gently. Keep drinking normally so your urine is pale. If the sting feels deep inside rather than on the skin, or comes with fever, it may be a urine infection and needs checking.
Will I go home with a catheter?
Some women do, particularly after a larger operation or when the wound sits close to the urethra. The nurses will teach you and whoever is caring for you how to empty the bag and keep it clean. You will be told when and where to come back to have it removed.
Can I use the health faucet in my bathroom?
Usually yes, once your team says the wound can get wet, but keep the pressure low and the water lukewarm. A strong jet can hurt a healing wound and push water into it. Many women find a jug of warm water gentler and easier to control in the first weeks.
I leak a little when I cough. Is that permanent?
Not always. Leaking after vulval surgery often improves over the following months, especially with pelvic floor exercises done correctly. Tell your team at follow-up. They can refer you to a continence physiotherapist. Do not be embarrassed to raise it, as it is a common and treatable problem.
How can I tell a urine infection from wound soreness?
Wound soreness is a surface sting where urine touches the skin. A urine infection usually causes burning inside, needing to go very often, cloudy or strong-smelling urine, and sometimes fever or pain low in the tummy. If you notice those, call your team or see a doctor the same day.
My mother cannot squat. What toilet should she use at home?
A Western-style toilet or a commode chair is much easier on the wound than squatting. Commode chairs and raised seats can be bought or rented from medical supply shops in most towns. Place it close to the bed for night-time use, and keep a jug and a soft towel beside it.
Should I drink less water so I do not have to go so often?
No. Less water makes urine stronger, which stings more and raises the chance of infection. It can also cause constipation, and straining puts pressure on the wound. Keep drinking normally unless a doctor has told you to limit fluids because of a heart or kidney condition.
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Sources
- NHS — Vulval cancer
- Cancer Research UK — Vulval cancer
- Macmillan Cancer Support — Vulval cancer
- American Cancer Society — Vulvar 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
Hygiene and Washing After Vulvar SurgeryA daily washing routine that protects the woundWound Healing in the Groin and PerineumWhat normal healing looks like, stage by stageDrains, Tubes, Lines and CathetersCaring for a catheter if you go home with oneComplications and Red FlagsSigns after surgery that need a doctor the same day
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