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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more| .
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The type of care you receive after your operation, and the speed of your recovery, will depend on the type of surgery you have. If the cancer is very small and only a minimal amount of skin is removed, your wound is likely to heal quickly. If your lymph nodes are removed, and particularly if you have more major surgery | (such as a radical vulvectomy), healing and recovery will take longer.
All the tissue that was taken away from your vulva will be carefully checked after the operation. If your lymph nodes were removed they will also be examined for signs of cancer. It takes a few days to get the results of these checks. Once your surgeon has the results they will talk them over with you. This will usually happen during your stay in hospital or at your first outpatient visit after your operation.
When you go back to the ward you will have a drip in your arm, which gives you fluids into a vein. The drip is usually taken out the next day, once you are eating and drinking normally again. You may also be given antibiotics through the drip to prevent you getting any infections. You will be given injections of blood-thinning medicine just under the skin to prevent blood clots.
You will usually have a tube (catheter) put in while you are under the anaesthetic, to drain urine from your bladder. The catheter will be taken out after a few days. If your lymph nodes have been removed, you will have a tube, called a drain, going into the groin. This is to drain any fluid that may collect there. The drain is connected to a small suction bottle. It will be removed from your groin when most of the excess fluid has been removed, usually within about seven days.
You may not have any dressings on the vulval wound, as the area is likely to be kept clean by gently rinsing it with fluid. This is usually done three times a day until you go home. If you do have a dressing, it will be removed after a few days and changed regularly to keep the area clean and to help the skin to heal. Stitches are usually dissolvable and will disappear as the wound heals.
If you have any groin wounds, they will be covered with dressings, which will need to be changed regularly. When the skin has healed you’ll be able to go home.
Once you’re at home, you won’t need to put dressings on the area, but it’s important to keep it clean and dry. The nurses on the ward will show you the best way to do this before you go home. If necessary, they will arrange for a district nurse to visit you at home to help with rinsing and keeping the area clean.
If you have had a skin graft, you may need dressings on the area from where the skin was taken (the donor site). Usually these dressings stay in place until new skin has formed. Your nurse will explain more about this to you.
You will need painkilling drugs for a few days after your operation. These may be given into a vein (intravenously), into the space around your spinal cord (an epidural), into a muscle (intramuscularly) or as tablets.
To begin with, you may be given intravenous painkilling drugs through a syringe connected to an electronic pump. The pump can be set to give you a continuous dose of painkiller. You may also have a hand control with a button you can press if you feel sore. This is called patient controlled analgesia (PCA). It’s designed so that you can’t give yourself too much, so it’s fine to press it whenever you’re uncomfortable.
Some women have painkilling drugs given into the space around the spinal cord (epidural). The drugs numb the nerves around the vulval area so that you don’t feel pain there. Epidural painkilling drugs are often given through a syringe and tubing attached to an electronic pump.
If you’re in pain| , let your nurses and doctors know as soon as possible. This will help them to give you the combination and dose of painkillers that is right for you.
Your bowels may not open for a few days after your operation. This is quite normal and can be due to a combination of the effects of the operation, painkillers and changes to your diet and activity levels. You may be prescribed laxatives to prevent constipation. If opening your bowels is painful or difficult, let your doctors know and they can prescribe extra laxatives to help.
The nurses will encourage you to start moving about as soon as possible after your operation. This is important for your recovery, as it helps to prevent problems such as chest infections or blood clots. If you have to stay in bed the nurses will encourage you to do regular leg movements and deep-breathing exercises. A nurse or a physiotherapist can help you to do the exercises.
If you have had lymph nodes removed from your groin you will be encouraged to put your feet up when you are sitting. This helps drain fluid in the legs.
There may be numbness or altered sensation around the operation site after surgery. This is due to the effects of surgery on the nerves close by. It often improves over a period of months.
Some types of vulval surgery can change the appearance of your genital area. How you approach looking at the vulval area after your operation will be very personal to you. If you have never looked at your vulva before, the idea of doing so may seem strange. You may not want to look at the area at all, or you may want a nurse with you when you look for the first time. A nurse can explain what has happened to the area and can offer professional support and advice. You may prefer to look alone or with a friend, partner or relative. Whoever you choose, make sure it’s someone that you trust and can talk to about your feelings.
Don’t force yourself to do things before you feel ready. If you decide to look at the area where your surgery was, it will probably seem odd, however well prepared you may have been. You may feel shocked, and this is understandable.
It’s common to feel upset and tearful after the operation. This can be a natural reaction to the diagnosis of cancer, the effects of the operation and to being away from home and family. You may find these feelings pass after a few days or you may continue to feel this way after you go home. Let your doctor or specialist nurse know if you aren’t feeling better or begin to feel depressed, as this may be a sign that you need extra help and support. You can read more about how you might feel | and find contact information for support organisations| .
When you go home you’ll need to take things easy for a few weeks. How long it takes you to recover will depend on the extent of your surgery.
If you’ve had major surgery, it is very important not to lift any heavy objects for at least 6-8 weeks. This will help the skin to heal completely.
It’s advisable to wait about eight weeks before going back to work, but you may need longer if you heal more slowly. You can usually start driving after six weeks, but your car insurance company may specify a longer time before you can drive again. It’s helpful to contact them to check.
If your operation involved removing only a small amount of skin, your recovery will be much quicker. Your doctor will advise you on what to expect and on the precautions you should take. Here are some other helpful tips to consider:
Before you leave hospital the staff can arrange district nurses and other help for you at home.
It’s safe to start to have sex again once your wound has completely healed. This usually takes about 6–8 weeks. But many women won’t feel physically or emotionally ready for sex until after much longer than this.
Most women feel shocked and upset by the idea of having surgery to the vulva. When these strong feelings are combined with the trauma of surgery and all the emotions that go with having a cancer diagnosis, it’s understandable that your sex life will be affected. We have more information about how surgery for vulval cancer may affect your sex life| .
You’ll be seen by your surgeon in the outpatient clinic after 4–6 weeks, to check how well your skin is healing and to discuss any problems. This is called a follow-up appointment. If you have any problems or worries before this contact your hospital doctor or the nurses on your ward for advice. Our section on follow up after treatment for vulval cancer| includes more information.
If the lymph nodes in your groin have been removed by surgery or you have had radiotherapy to this part of your body, there is a risk you could develop swelling of your leg or legs. This is called lymphoedema| .
The lymph nodes normally help to remove lymph fluid from your legs. Taking the lymph nodes away or irradiating them can block the flow of lymph fluid. If this happens fluid will collect in the tissues under your skin, making your legs swell. Lymphoedema can develop a few weeks or several years after treatment.
The following suggestions can help to lower your risk of getting lymphoedema or lessen its severity if it does develop.
Protect the skin on your legs and feet Keep your skin clean and dry and apply moisturising cream daily to keep it supple. Don’t get your legs waxed. If you shave your legs, use an electric razor, to avoid cuts. Wear long trousers when gardening to avoid being scratched. Protect your skin in the sun and avoid getting sunburnt.
Look after your feet Wear well-fitting footwear. Wash and dry between your toes carefully. If you notice any signs of athlete’s foot, such as soreness and/or peeling between the toes, treat it straight away. Use nail clippers instead of scissors to cut your nails, as there’s less risk of accidentally cutting the skin with clippers.
Avoid infection in your legs and feet If you get a graze or cut treat it with antiseptic and keep it clean until it heals. See your GP if there are any signs of infection such as redness, warmth or tenderness.
Exercise Gentle exercise such as walking and swimming helps lymph drainage, but exercising too hard can lead to lymphoedema for some people. Ask your doctor or specialist nurse when you can start exercising and what types of exercise are right for you.
Keep to a healthy body weight Being overweight can increase your risk of lymphoedema. If you feel you need to lose weight talk to your nurse or doctor for advice.
Put your feet up Raise your feet and legs when you are sitting to help lymph drainage. Make sure your feet are well supported on a pillow or cushion if possible. Don’t cross your legs when sitting. If you have to sit with your feet down for a long time, such as on a long journey, wear support stockings to help lymph drainage. Try to avoid standing for long periods of time.
Avoid temperature extremes Test the temperature of water before bathing to make sure it’s not too hot. Avoid using saunas or hot tubs.
Contact your nurse or doctor If you notice any swelling, redness, pain or heat in your foot or leg then ask your doctor or nurse for advice.
Lymphoedema can be improved with special massage techniques, exercises, bandaging and support stockings. Many hospitals have a nurse or physiotherapist who specialises in treating lymphoedema. The earlier treatment is started, the more likely it is to be successful, so let your doctor know if you notice even mild swelling of your leg or foot.
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