A vulvectomy is a surgery that removes part or all of the vulva, the outer area of the female genitalia surrounding the opening of the vagina. It is most commonly performed to treat vulvar cancer or precancerous changes on the vulvar skin. The scope of the surgery ranges widely, from removing a small area of tissue to removing the entire vulva, depending on the size and nature of the growth being treated.
Why a Vulvectomy Is Performed
The two main reasons for a vulvectomy are vulvar cancer and a precancerous condition called vulvar intraepithelial neoplasia (VIN), where abnormal cells develop on the skin of the vulva. VIN is not cancer, but it can progress to cancer over time, particularly in people who are immunocompromised or have widespread lesions.
For precancerous changes, less invasive options like laser therapy sometimes work. However, larger lesions, especially those over hair-bearing areas, are more effectively treated with surgical excision. A full removal of all vulvar skin is rarely needed but may be appropriate when lesions are widespread and run together across multiple areas of the vulva.
Types of Vulvectomy
The word “vulvectomy” covers several different operations, and the differences between them matter. The type you’d have depends on whether the condition is precancerous or cancerous, how deep it extends, and how much tissue is involved.
- Simple partial vulvectomy (wide local excision): Removes the tumor along with most or all of the inner and outer labia, including skin and the tissue just beneath it. This is commonly used for precancerous lesions or new suspicious growths in someone previously treated for vulvar cancer.
- Partial or modified radical vulvectomy: Removes part of the vulva along with deeper tissue beneath the skin. This is the standard approach for treating vulvar cancer while preserving as much anatomy as possible.
- Simple vulvectomy: Removes the entire vulva and some tissue just under the skin.
- Complete or total radical vulvectomy: Removes the entire vulva along with deep underlying tissue. This is rarely performed today, as surgeons increasingly favor more conservative approaches that remove less tissue while still achieving clear margins around the cancer.
What Recovery Looks Like
Recovery timelines vary considerably based on how extensive the surgery was. For a smaller excision, you can typically resume normal daily activities relatively quickly, with no lifting restrictions. You’ll need to avoid sexual activity, tampon use, and submerging the area in water (tub baths, pools, lakes) for about one month. Dissolving sutures typically break down on their own within about eight weeks.
For more extensive surgeries, the recovery period is longer and more restrictive. Sitting comfortably requires a soft pillow or donut cushion for the first three to four weeks. If you had major or reconstructive surgery, you may not be able to sit normally for up to eight weeks. You’ll have lifting restrictions of no more than 10 pounds, and high-energy activities like jogging or contact sports are off limits until your surgeon clears you.
Incisions in the groin area (if lymph nodes were also addressed) are closed with staples or sutures that stay in place until a follow-up visit, typically two to four weeks after surgery. Most people can drive again about a week after the procedure. Travel is generally discouraged until after that first post-operative appointment.
Possible Complications
Vulvectomy, particularly for cancer, carries a meaningful risk of complications. The three most common are wound breakdown, fluid collections near the surgical site, and chronic swelling in the legs.
In a study of 121 patients who had vulvar cancer surgery, about 18% experienced wound breakdown (where the incision partially opens rather than healing cleanly), roughly 18% developed a fluid collection called a lymphocele, and about 20% developed chronic leg swelling (lymphedema) in the years following surgery. The ranges reported across broader research are even wider: 17 to 39% for wound breakdown and 14 to 49% for lymphedema. These numbers reflect the challenges of healing in an area that’s constantly in contact with moisture and movement, and they underscore why careful post-operative wound care is so important.
Wound Care at Home
Keeping the surgical area clean is central to recovery. Warm sitz baths, where you sit in a shallow basin of warm water, help increase blood flow to the area, reduce pain and swelling, and support healing. The warm water relaxes the surrounding muscles and soothes irritation. If you’re using a plastic sitz bath basin, clean it thoroughly before each use and don’t share it with anyone, as bacteria can cause infection in healing surgical tissue.
Your surgical team will give you specific hygiene instructions. Generally, the goal is to keep the area dry between cleanings and avoid anything that introduces bacteria, including baths in standing water, swimming, and sexual activity during the initial healing window.
Reconstruction After Surgery
When a significant amount of tissue is removed, surgeons can reconstruct the area using tissue from nearby parts of the body. Skin grafts are generally not ideal for this region because the area needs tissue with enough thickness and flexibility to function comfortably. Instead, surgeons use flaps, which are sections of skin and underlying tissue moved from adjacent areas while keeping their blood supply intact.
For small or moderate defects, local flaps work well. These are taken from tissue right next to the surgical site, matching the thickness and texture of the original area closely. For larger defects, or in cases where previous surgery or radiation has limited local tissue options, surgeons can use pedicled flaps from the thigh, groin, or abdomen. In some cases, multiple flaps are combined to fully restore the area. The goal of reconstruction is both functional and cosmetic: closing the wound securely, preserving comfort, and restoring anatomy as closely as possible.
Sexual Health and Body Image
Vulvectomy affects sexual function and how people feel about their bodies, and these effects are real and well documented. In a survey-based study of 41 women who had undergone the procedure, there was a significant change in body image after surgery. Sexual frequency dropped substantially, and many women experienced difficulties with desire, arousal, and aversion to sexual activity.
One notable finding: the extent of the surgery did not predict the degree of sexual difficulty. Women who had smaller procedures reported similar rates of sexual dysfunction as those who had more radical operations. Depression played a significant role. Women who were depressed at the time of the survey were more likely to experience sexual aversion and tended to have greater body image disturbance and overall sexual dysfunction. This suggests that emotional and psychological support after vulvectomy is just as important as physical recovery.
Most people can eventually resume sexual activity once incisions have fully healed, but the timeline depends on the extent of surgery and the areas removed. Your surgeon can give you specific guidance on when it’s safe to start, and working with a therapist or counselor who specializes in sexual health can help address the emotional side of recovery.