What happens after surgery?

After your operation, you will be encouraged to start moving about as soon as possible. But if you have to stay in bed you will 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. The drip and drain 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

Recovery

How quickly you recover will depend on the type of operation you have. You will be encouraged to start moving around as soon as possible. While you are in bed, it is 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. You may need to continue the injections after you go home. Your nurse will teach you or a relative how to give the injections, or arrange for a district nurse to visit you at home.

If you have had lymph nodes removed from your groin, you will be encouraged to put your feet up when you are sitting down. This helps to reduce leg swelling.

I have had a few surgeries. After my last operation I could not drive or sit properly for around four weeks, and after that I had to be careful how I sat down. I found that sitting on a rubber ring helped.

Helen, after vulva surgery


Drips and drains

You will be given fluids into a vein in your hand or arm. This is called a drip or intravenous (IV) infusion. This will be taken out as soon as you are eating and drinking normally.

You will usually have a tube (catheter) to drain urine from your bladder. It is usually taken out a few days after your surgery, but sometimes it may need to stay in for longer.

If your lymph nodes have been removed, you will have a drainage tube 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. If needed, you can go home with the drain. A practice nurse or a district nurse may check it when you are at home. Or you might have it checked and removed at the hospital.


Pain

It is normal to have some pain or discomfort for a few days after surgery. But this can be controlled with painkillers. It is important to let your doctor or nurse know as soon as possible if the pain is not controlled, so that they can change your painkillers.

Immediately after your operation you may have strong painkillers. You may be given painkillers through one of the following straight after your operation:

  • By injection into a muscle – the nurses will do this for you.
  • An epidural – this is a small, thin tube in your back that goes into the space around your spinal cord. An epidural will give you continuous pain relief.
  • A patient-controlled analgesia pump (PCA pump) – the pump is attached to a fine tube (cannula), in a vein in your arm. You control the pump using a handset that you press when you need more of the painkiller. It is fine to press the handset whenever you have pain. The pump is designed so that you cannot give yourself too much painkiller.

When you no longer need strong painkillers, you will be given milder painkillers as tablets. You may be given a supply to take home. Tell your nurse or doctor if you are still in pain, so they can adjust the dose or give you a different painkiller.


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 water and carefully dried. 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 helps with heal-ing by encouraging blood flow to the affected area. This can be done in hospital or managed at home by a district nurse.

If you do not have stitches that dissolve, your stitches or staples will probably be removed about 7 to 10 days after your operation.

If you have had a skin graft, you may need dressings on the area the skin was taken from (donor site). Usually these dressings stay in place until new skin has formed. How long the site takes to heal will depend on how much skin was removed. Your doctor or nurse will explain more about this to you.

Wound infection

Wound infections can be a complication of the surgery. Signs of wound infection include:

  • heat
  • redness
  • swelling
  • discharge (fluid or pus coming from the wound)
  • feeling unwell
  • a fever or high temperature.

Tell your nurse or doctor if you get any of these symptoms, even after you go home.


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.


How your vulva looks

After surgery, you will have some bruising and swelling around your vulva. This should gradually disappear with time.

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 someone with you when you look for the first time. A nurse can explain what has happened to the area and give you support and advice. You may prefer to look alone or with a nurse, partner, relative or close friend. Whoever you choose, make sure it is someone that you trust and can talk to about your feelings.

Do not 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. People cope with changes in appearance differently. Some people may not be very upset by them. Others find these changes harder to cope with. You may want to talk about your feelings with an organisation that specialises in vulval cancer.


Getting support

It is 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 are not feeling better or if you begin to feel very low, as you may need extra help and support.

Some hospitals have local support groups for women who have gynaecological cancers. If you think you would find a support group helpful, tell your nurse specialist. They can tell you if there is 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

Back to Surgery

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.