What happens after surgery?

After your operation you‘ll be encouraged to start moving about as soon as possible. But if you have to stay in bed you’ll be shown how to do leg and breathing exercises.

You may have a drip into your arm to give you fluids. You may also have a drainage tube into the groin if you had lymph nodes removed. These will be removed as soon as possible.

It’s normal to have some pain or discomfort for a few days, but your nurse can give you painkillers to help. 

You may not have a dressing in the vulval area but may have dressings in the groin if you’ve had lymph nodes removed.  

Surgery can change the appearance of the vulva and this may be upsetting. If you want to look at the area where you had your surgery, you can ask your nurse to be with you so you can ask her any questions.

If you feel you need extra support after your surgery, speak to your GP or the hospital team. They can suggest other sources of support.

After your operation

How quickly you recover will depend on the type of operation you have. You’ll be encouraged to start moving around as soon as possible. While you’re in bed, it’s important to move your legs regularly and do deep breathing exercises. This is to help prevent chest infections and blood clots. A physiotherapist will show you how to do these exercises. You may also have regular injections of a blood thinning drug to help reduce the risk of blood clots.

If you’ve had lymph nodes removed from your groin, you’ll be encouraged to put your feet up when you’re sitting down. This helps fluid to drain in your legs.


In the ward

After your operation, you’ll be given fluids into a vein in your hand or arm. This is called a drip or intravenous infusion. Once you’re eating and drinking normally again, it’s taken out. You’ll usually have a tube (catheter) that drains urine from your bladder. It’s put in during the operation. It may be taken out a few hours after your surgery, or it may need to stay in for longer.

If your lymph nodes have been removed, you’ll have a tube (drain) going into your groin. This is to remove any fluid that may collect there. The drain is connected to a small suction bottle. Your nurse will remove it from your groin when most of the excess fluid has been drained off – this usually takes a few days.


Your wound

You may not have any dressings on your vulval wound. The area is likely to be kept clean by being gently rinsed with fluid. This is usually done three times a day until you go home. If you do have a dressing, your nurse will remove it after a few days and change it regularly, to keep the area clean and help the skin to heal.

If you have any wounds in your groin area, they will be covered with dressings, which will need to be changed regularly. Sometimes, wounds near the groin can heal more slowly than wounds in other areas. You may have vacuum-assisted (VAC®) therapy. VAC therapy uses a pump or suction machine, which is attached to a dressing on your wound. It draws fluid out of the wound and also helps with healing by encouraging blood flow to the affected area. This can be done in hospital or managed at home by a district nurse.

If you don’t have stitches that dissolve, you will probably have your stitches or staples removed about 7–10 days after your operation.

If you’ve had a skin graft, you may need dressings on the area the skin was taken from. Usually these dressings stay in place until new skin has formed. Your nurse will explain more about this to you.

Wound infection

This can be a complication of the surgery. Signs of infection include warmth, redness and swelling around the wound, or discharge coming from it. You may also feel unwell with a fever. Tell your nurse or doctor if you get any of these symptoms, even after you go home.


Pain

There are effective ways to prevent and control pain after surgery. Depending on the extent of your surgery, you may need a strong painkiller for the first day or two after your operation. There are different types of strong painkiller:

  • You may have painkillers by injection into a muscle. The nurses will do this.
  • You may have a patient-controlled analgesia (PCA) pump. This means you can give yourself an extra dose of pain relief if you feel sore. The machine is set to make sure you can’t have too much.
  • Some women have painkillers through an epidural infusion for the first few days. The anaesthetist puts a fine tube into your back during surgery. They connect the tube to a pump to give you a continuous dose of painkillers.

When you no longer need strong painkillers, you will have milder painkillers as tablets. Tell your nurses and doctors if you’re in pain, so they can give you the dose of painkillers that’s right for you.


Constipation

You may not have bowel movements for a few days after your operation. This is normal and may be due to the combined 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 so they can prescribe extra laxatives to help.


Changes to your vulva

After surgery, you may have some bruising and swelling around your vulva. This should gradually disappear with time. You may have some numbness or altered sensation around the area after surgery. This is because of 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’ve 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’s happened to the area and offer support and advice. You may prefer to look alone or with a partner, relative or friend. 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 you had surgery, remember that you may feel shocked, even if you were well prepared. This is understandable. You may want to talk about your feelings with an organisation that specialises in vulval cancer.


Getting support

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 being away from home and family. You may find these feelings go after a few days, or you may continue to feel this way after you go home. Tell your doctor or specialist nurse if you aren’t feeling better or if you begin to feel very low, as you may need extra help and support. You can read more about coping with your feelings. We also have contact details for support organisations.

Some hospitals have local support groups for women who have gynaecological cancers. If you think you’d find a support group helpful, tell your clinical nurse specialist. They can tell you if there’s one in your hospital or local area.

You could also join an online support group. Visit our Online Community where you can chat with other people who have vulval cancer, or just read through the posts or blogs other people have written.

‘Look after yourself and take it easy. I still get tired, so I do a little and rest a little. We went on holiday after my treatment – it gave me something to look forward to.’ Patricia

Patricia

Back to Surgery explained

What happens before the surgery?

Your surgeon will discuss your surgery and how you can prepare with you – this is a good time to ask any questions you have.

Who might I meet?

A team of specialists will plan your surgery. This will include a surgeon who specialises in your type of cancer.