Find out how you’ll feel after your surgery, possible problems after surgery and your follow up appointments.
Follow up after surgery
You’ll have follow up appointments to check your recovery and sort out any problems. They‘re also your opportunity to raise any concerns you have about your progress.
People react very differently to vulval cancer surgery. The vulval and genital areas are private parts of your body and you may find it very difficult to talk about how you are feeling. Your self confidence may be affected and you may need time to come to terms with the changes surgery will bring.
Feelings may be mixed with relief that you've had treatment. Your initial feelings of fear, shock or anger should improve, particularly with the support from family or friends.
If these negative feelings don't go, you may be becoming depressed. Talk to your doctor or specialist nurse if you are worried about this. Counselling may help or your doctor might suggest a course of anti depressants. This isn't unusual after cancer treatment. It won't be forever, and will help you over a difficult period.
It is common for women to feel less feminine after this type of treatment. Some have feelings so strong that they describe them as feeling assaulted after their operation. Contact one of the self help organisations if you feel like this. It may really help you to realise that other women who've been through the same thing feel the same way.
How you might look
Immediately after surgery, your genital area will be very swollen and bruised. This will heal but there will be changes in how your genital area looks. The inner and outer lips of your vagina may have been removed which will make this area look very different. This may come as quite a shock when you first see it.
It can be very hard to accept sudden changes in your body that you are not happy with. It is not unusual for people who have had surgery to their genital area to feel angry, confused and upset.
You may not feel as physically attractive to your partner. Even though people may not be able to see the changes, you may worry that you do somehow look different.
The important thing to remember is that those closest to you will not view you any differently as a person. They will want to support you as much as they can. Shutting them out will only make you feel more isolated and less able to cope with things.
Who can help
There are several things that may help you cope with changes in the way your genital area may look after surgery. They may not take away all the emotional pain but they can make things easier. They include:
- Talking to your surgeon before your surgery
- Talking to a woman who has had a similar experience
- Talking to the people close to you
- Getting help and support
Talking to your surgeon before your surgery
This is probably one of the most important things you can do, even if you feel at the time that you are not ready to know how surgery may change your genital area. But talking to your surgeon before your operation really will help you deal with things later on.
Ask your surgeon to be very honest with you and find out exactly what they are going to do and how you will look. You are likely to be very swollen and sore immediately after your surgery, but this is temporary and not how you will look forever. Do not be afraid to ask your doctor questions. Your surgeon will be sensitive to how worried you are about changes in your body and will want to reassure you.
Talking to a woman who has had a similar experience
This may not help everyone so do not feel you have to do this. But some people find it very helpful and reassuring to speak with someone else who has had to cope with this type of surgery. Your surgeon may be able to put you in touch with someone who has had a similar operation to yours.
Talking to the people close to you
The best support you are likely to get is from your close family and friends. Some people may choose not to share too much with these people because they do not want to upset them, or feel too shy about their surgery to talk very openly. But you will be surprised how much it can help just to share your feelings.
If you are having problems with your intimate and sexual relationships because you feel that you are no longer attractive, try letting your partner know how you are feeling.
Vulval surgery will affect your physical ability to have sex. Your emotions may change your sexual feelings.
This type of surgery does not affect your ability to become pregnant. Discuss this with your doctor if you are having any other type of treatments such as radiotherapy or chemotherapy. These treatments may affect your fertility.
It can take several months for the vulval area to heal and for sensation in the area to improve. Any scarring may cause your vagina may be much tighter so you may need to use a vaginal dilator to stretch it.
If you have had your clitoris removed, it will feel different when you have sex. You may find it more difficult to reach a sexual climax (orgasm).
You may not feel like having sexual intercourse for some time but you can still enjoy intimacy with touch and talking to your partner. Women who've had this type of treatment tell us that orgasm is possible, even if you've had your clitoris removed, but may take longer.
You may worry about the first time you let your partner see or touch your body again. Some women need time to be alone and come to terms with what has happened. This is very natural and some women want to build up their courage to face someone else – even a deeply loved partner. Others need almost instant comfort and find loving touch will relieve their fear of being rejected.
You may find it difficult to relax during sex. There are books and tapes available that explain relaxation techniques. Your local cancer support group may have material available, or they may have classes at their group. Your specialist nurse or library may have relaxation tapes or books you can borrow.
This can be a difficult time for your partner as well. They may not know how to give you the love and support you need. Try to involve them in discussions with your doctor about your surgery and how it may affect your relationships.
If you are not in a relationship you may feel worried about starting a new one after your operation. Talk to your gynaecological nurse specialist. You may also find it helpful to get in touch with someone who has been through this type of surgery.
Swelling in your groin or legs
After surgery, the area will be swollen. This should go down within a few weeks. If you have had lymph nodes removed, or have had radiotherapy to your lymph nodes, there is a risk of developing swelling later on. This swelling is called lymphoedema (limf-o-dee-ma).
The lymph nodes are part of your body's drainage system. If you've had lymph nodes removed from your groin, this can affect the natural circulation and drainage of tissue fluid from the leg on that side.
Your leg could become very swollen and painful. If you think you are developing swelling, it is very important to let your specialist know right away. To start with, your shoe may feel tighter than normal.
The doctor will probably want to see and examine you then refer you to a lymphoedema specialist. The earlier you get this problem diagnosed, the more likely it is that the lymphoedema specialist will be able to get it under control.