Medical Oncologist
CION Cancer Clinics
Vulvectomy: what the operation involves | CION Cancer Clinics
A vulvectomy is an operation to remove part or all of the vulva, the outer female genital area, usually because a cancer or a pre-cancer has been found there. You are asleep under general anaesthetic. The surgeon removes the affected skin with a rim of healthy tissue around it, often checks the lymph nodes in the groin, and closes the wound. This page walks through what happens before, during and after, and what it cannot tell you. 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
- What is a vulvectomy, and why is it done?
- What actually happens, from arriving to waking up?
- What the surgeon removes, and what is checked
- 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 vulvectomy surgery
The short answer
What is a vulvectomy, and why is it done?
A vulvectomy removes the part of the vulva where a cancer or an abnormal patch of skin sits, together with a rim of healthy tissue around it so that nothing is left behind at the edges. How much is taken depends on the size, depth and position of the growth, not on a fixed rule.
Why surgery rather than something else
For most vulval cancers that have not spread far, surgery is the usual first treatment. The growth sits on the surface, where the surgeon can see it and remove it whole. Radiotherapy and chemotherapy are used instead when the growth is too large, or too close to the bladder or the back passage, to remove without harm.
Who this operation is not for
It is not the usual choice when the cancer has already spread beyond the groin, or when the person is too unwell to be safely put to sleep. In those situations the team looks at radiotherapy, chemotherapy, or treatment aimed at comfort. It is also not done for the itchy skin condition lichen sclerosus on its own, which is treated with creams.
The word covers a wide range of operations. Most procedures for early vulval cancer remove a small area, not the whole vulva.On the day
What actually happens, from arriving to waking up?
Before theatre
You arrive fasting. You will have been told which of your usual medicines to take that morning; follow that exactly. The anaesthetist meets you, and the surgeon marks the area and goes through the consent form again.
Going to sleep
You are fully asleep under general anaesthetic. Some teams add a spinal injection for pain relief after you wake. A thin tube called a catheter is placed in the bladder while you are asleep, so urine does not run over a fresh wound.
The operation itself
The surgeon cuts around the growth with a margin of healthy skin and removes it in one piece. If the groin lymph nodes need checking, that is done through separate small cuts in the groin creases. Theatre time ranges from about an hour for a small excision to several hours when the groins are included.
Closing and waking
The edges are closed with stitches that dissolve. If the gap is too wide, a flap of skin from nearby fills it. Drains are usually left in operated groins. You wake in recovery and go back to the ward. A small excision may mean going home the next day; a radical operation usually means several days in hospital.
Not sure whether this applies to you?
Ask an oncologistInside the operation
What the surgeon removes, and what is checked
Four things can happen in the same operation. Not every person needs all four; your consent form lists which apply to you.
The growth, with a margin
The cancer and a rim of normal-looking skin around it are removed together, because cancer cells can sit just beyond what the eye can see. The pathologist later measures whether that rim was clear.
The groin lymph nodes
Vulval cancer spreads first to the groin nodes, so for most growths deeper than a thin surface layer the nodes on one or both sides are checked, either by removing a single sentinel node or by clearing the whole group.
Not usually needed when
- The growth is a pre-cancer only
- The cancer is very shallow on the biopsy
The tissue goes to the laboratory
Everything removed is examined under the microscope. The report, usually ready within one to two weeks, says how deep the cancer went, whether the margin was clear and whether any node contained cancer.
Closing, and sometimes rebuilding
Most wounds are closed directly. When a large area has been removed, a plastic surgeon may move skin from the thigh or buttock to cover the gap. Ask beforehand whether a flap is likely, because it changes the recovery.
!
One thing that cannot wait once you are home
Bleeding that soaks through a pad, a fever with a wound that is hot, red and spreading, or being unable to pass urine at all need same-day care. Call the helpline or go to the nearest emergency department and say you have had vulval surgery. Do not wait to see whether it settles overnight, and do not put any cream or powder on the wound first.
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On your consent form
Words you will see, in plain language
- Wide local excision
- Removing the growth with a rim of healthy skin around it, leaving the rest of the vulva in place. The most common operation for a small cancer.
- Radical vulvectomy
- Removing a larger area, down to the deeper layer, sometimes including most or all of the vulva. Used for larger or deeper cancers.
- Margin
- The rim of normal tissue around what was removed. A clear margin means no cancer cells were found at the edge under the microscope.
- Sentinel node
- The first lymph node in the groin that fluid from the vulva drains to. If it is free of cancer, the other nodes are very likely to be free too.
- Inguinofemoral node dissection
- Removing the whole group of lymph nodes in one or both groins, rather than a single node.
- VIN
- Vulval intraepithelial neoplasia: abnormal cells in the surface layer that are not yet a cancer but can become one.
Commonly believed
Four things families tell us, and what is actually true
"Everything down there will be removed."
For most women it will not. The operation removes the growth and a margin around it. Removing the whole vulva is reserved for large or widespread cancers. Ask the surgeon to draw on a diagram which parts will be taken and which will stay.
"She is too old to go through an operation."
Age on its own does not decide this. Vulval cancer is most common in older women, and many in their seventies and eighties have the operation. What the anaesthetist weighs is the heart, the lungs, the kidneys and how active the person is day to day.
"Cutting into it will make the cancer spread."
It does not. Removing the growth whole, with a margin, is how the cancer is taken out of the body. Delay is what allows it to grow deeper and reach the groin nodes, and that does change the treatment needed.
"Once it is cut out, nothing else will be needed."
Often true for a small, shallow cancer with clear margins. But if the pathology report shows cancer in a groin node or close to the edge, radiotherapy is usually advised afterwards. The report decides, not the operation.
Being straight with you
What this page cannot tell you, and what to ask
This page describes the operation in general. It cannot tell you which version you will have, because that depends on your biopsy, your scans and an examination by the surgeon. It also cannot tell you how the cancer will behave afterwards. That comes from the pathology report, and even then only in part.
Questions worth asking before you sign
Which type of vulvectomy is planned, and why. Whether the groin nodes will be checked, and by sentinel node or full clearance. Whether a skin flap is likely. How many days in hospital to expect. What the area is likely to look like once healed. Who to call at night if something goes wrong. Write the answers down; most people remember little of the first conversation.
Bring the person who will help with wound care at home; they need to hear the instructions first-hand.
Whether to go ahead with surgery is a decision between you and your treating team. This page gives you the questions, not the answer.Questions we are asked
Common questions about vulvectomy surgery
How long does the operation take?
A wide local excision on its own usually takes about an hour. A radical vulvectomy with both groins cleared can take several hours, and longer if a skin flap is used to close the wound. The surgeon will give the family a rough figure on the day.
How long will I be in hospital?
It varies more than most operations. A small excision may mean one night. A radical operation with groin drains usually means several days, and the drains sometimes stay in after you go home. How the wound behaves in the first days decides it.
Will I have a catheter, and for how long?
Yes, a bladder catheter is placed while you are asleep so that urine does not run over the fresh wound. For a small excision it often comes out the next day. After a larger operation it stays until the swelling has settled enough for you to pass urine comfortably.
Will I need radiotherapy afterwards as well?
Not always. It is usually advised when the pathology report shows cancer in the groin nodes, or when the margin around the removed growth was very close. For a shallow cancer with clear margins and clear nodes, surgery alone is usually enough. Nobody can say before the report is back.
Can it be done as keyhole surgery?
The vulval part cannot, because the growth is on the surface and is removed directly. Some centres use keyhole methods for the groin nodes, but this is not standard everywhere. Ask your centre what approach they use for the groin and why.
Will I be able to have sex afterwards?
Many women do, once the wound has fully healed, though sensation and comfort can change depending on how much was removed and whether the clitoris was involved. Ask the surgeon before the operation, not after. There is a separate page on sex and sensation after vulvectomy.
Can my daughter stay with me on the ward?
One attendant is usually welcome, and for this operation it helps. The nurses will show whoever is caring for you how to clean the area and change pads, so the same routine continues at home.
Is vulvectomy covered by Aarogyasri or insurance?
Usually yes, as part of an approved cancer treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Pre-approval takes a few days, so start it as soon as surgery is planned. Call the helpline with your card details and we will check your cover.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
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Sources
- Cancer Research UK — Surgery for vulval cancer
- Macmillan Cancer Support — Vulval cancer
- National Cancer Institute — Vulvar Cancer Treatment (PDQ) - Patient Version
- NHS — Vulval cancer
- American Cancer Society — Surgery for 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
Wide Local Excision vs Partial vs Radical VulvectomyWhich version of the operation is whichGroin Node Surgery With VulvectomyWhy the groin is often part of the same operationWound Healing in the Groin and PerineumWhat the first weeks at home look likeAnaesthesia for Cancer SurgeryWhat being put to sleep actually involvesCost, Insurance and Schemes for Cancer SurgeryAarogyasri, CGHS and cashless cover explained
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Been told you need vulval surgery?
Send us the biopsy report and any scans, or call the helpline. A surgical oncologist will explain which operation is being suggested and why. One helpline serves every CION centre.