Vulvectomy in Cuttack

Vulvectomy is the procedure of treating vulvar cancer of the female outer genitals. 

The vulva is the outer lining of the urethra, vagina including the clitoris. The treatment is dependent on the size, location, extent, and health of the patient.

The procedure used to treat vulvar cancer include:

The operation involves removing cancer-affected areas as well as some part of the normal tissue around such that the cancerous cells are removed eliminating the chance of recurrence. 

This procedure is also called wide local excision or radical excision.

 In case a part of the vulva is removed the treatment is called Partial Vulvectomy. Where the entire vulva including the underlying tissues are removed the procedure is called Radical Vulvectomy. 

Vulvectomy cannot be just practiced as a solitary procedure but needs to be clubbed with radiation therapy or chemotherapy for more effectiveness. 

In intense cases, doctors might first prescribe a combination of radiation therapy or chemotherapy to shrink the tumor and then perform the surgery. 

During the surgery, the doctor would remove lymph nodes, mostly the first lymph nodes, as cancer can spread through them.

 The lymph nodes are then sent for biopsy, a positive result indicated that cancer has spread. 

• Excision

Excision is an associated process in vulvectomy where the edge of normal skin fringing the affected skin, and a thin layer of fat below that, are removed (excised)

• Radiation Therapy

Radiation therapy is making the use of high-powered beams, like an x-ray to sensitize the vulva and kill the cancer cells.

 This therapy also shrinks cancer making it more accessible and easier to operate.

In some cases, chemotherapy is used to make the region vulnerable to radiation therapy.

The doctor might recommend radiation therapy if cancer cells are detected in your lymph nodes. 

This is to kill any cancer cells left after the surgery. Radiation and chemotherapy may be used together in these situations.

• Chemotherapy

Chemotherapy is a drug treatment and administers drugs through veins in the arm or orally, to prevent the spread of cancer to adjoining areas.

Chemotherapy is used to shrink cancer, so the surgery can be more successful.

• Laser Surgery

In these procedures, a laser beam is targeted on cancer affected area to burn the skin layer.  This treatment is effective in the initial stages and not effective n invasive cancer.

• Targeted Drug Therapy

Targeted drug treatments treat specific abnormalities in the cancer cells.

 The drug treatment blocks the abnormalities and causes cancer cells to die. This therapy is used in advanced stages of vulvar cancer.

• Immunotherapy

Immunotherapy acts by using the body's immune system to fight cancer cells.

 Immunotherapy attacks on the protein layered under which the cancer cells are protected to expose them and thus the natural immune system can act.

• Vulvar reconstruction

Vulvar reconstruction is an associated procedure and might be applicable in cases where a large skin area of the vulva is removed and requires skin grafting.

 The grafting can be done by the oncologist or the gynecologist. Further reconstruction can be done through plastic or reconstructive surgery post vulvectomy.

Vulvar surgery can bear a lot of complications including wound healing, infections, and non-acceptance of the graft.

The complications increase and become riskier as more tissues are removed. Hygiene and wound care are very strictly recommended.

The surgery might affect the flow of urine stream, because of the removal of tissues from one or either side of the urethral.

There could be the formation of a fluid-filled cyst or blood clots that might reach the lungs.

Low sexual desire

Urinary infection

Bleeding

Pain, tenderness, or numbness of the vulva

Unhealing wound

Blood clots and waterlogging in the legs

The tightness of the vagina

Inability to have an orgasm

Chronic leg swelling

Reaction to anesthesia

Infection