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Having your operation for vulval cancer

Women discussing vulval cancer

This page tells you about having your operation for vulval cancer. You can find information about

 

A quick guide to what's on this page

Having your operation for vulval cancer

When you go into hospital for your operation, the anaesthetist and either your surgeon or a member of their team will see you. The doctor will ask you to sign a consent form for the operation. They should give you a detailed explanation of what to expect. Do ask as many questions as you need to.

Before your operation, your nurse may shave your pubic hair. This reduces the risk of wound infection. Your nurse or physiotherapist will teach you breathing and leg exercises to do after your operation, to help prevent blood clots or chest infections.

After your operation

When you wake up you will have a drip in place, and perhaps a tube to drain your wound or a tube (catheter) to drain urine from your bladder. You may or may not have a dressing covering your wound.

Your wound is bound to be sore at first. There are many different types of painkilling drugs you can have. It is important to tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you.

Getting over your surgery

You should get over a small operation quite quickly. After a bigger operation, you should allow at least 6 weeks. Do bear in mind, though, that it takes longer than that for some women to recover. You will find moving around difficult at first. Try not to walk too much for the first few weeks, as this will put a strain on the healing wound.

 

CR PDF Icon You can view and print the quick guides for all the pages in the treating vulval cancer section.

 

 

Before the operation

Before your operation, your surgeon will need to be sure you are fit enough to make a good recovery. You may have had some of these general tests when your cancer was being diagnosed. If so, you won’t need to have them again. You are most likely to have these tests as an outpatient. But some hospitals do them when you come into hospital for your operation. Depending on the extent of the operation your surgeon may want

  • Blood tests to check your general health
  • A chest X-ray to check your lungs are healthy for the anaesthetic
  • An ECG to check your heart is healthy

Your nurse or a physiotherapist will teach you breathing and leg exercises. You can help yourself to get better by doing these exercises after your operation. You should do them as often as you are told you need to.

Breathing exercises will help to stop you getting a chest infection. And leg exercises will help to stop clots forming in your legs. Both these complications of surgery can happen because you are not moving around as much as you would normally be. Your nurses will encourage you to get up and about as soon as possible after your operation. But if you have had major surgery, you will be in bed for the first couple of days.

Below is a short video showing breathing and circulation exercises after surgery. Click on the arrow to watch it.

 



 

View a transcript of the video showing breathing and circulation exercises after surgery (opens in new window)

When you go into hospital for your operation, the anaesthetist and either your surgeon or a member of their team will see you. The doctor will ask you to sign a consent form for the operation. They should give you a detailed explanation of what to expect and how you will feel when you come around after the anaesthetic has worn off. Do ask as many questions as you need to. It may help to make a list of your questions before you go into hospital for your operation. The more you know about what is going to happen, the less frightening it will seem. Don’t worry if you think of more questions later. Just speak to your nurses. If they cannot answer your questions, they can contact the doctor to come and talk to you again.

Before your operation, your nurse may shave your pubic hair to make sure the operation site is as clean as possible. This is done because it reduces the risk of an infection getting into your wound. This may be done on the ward. Or you may have your shave in the operating theatre after you have had your anaesthetic.

On the day of your operation, your nurse may ask you to put on elastic stockings, sometimes called TED stockings. These are to help prevent clots in your legs forming while you are in bed after surgery. You will be asked to keep them on for a few days after the operation.

 

After your operation

When you wake up, you may have a drip in place to give you fluids until you are eating and drinking again. You may be given antibiotics through the drip to help prevent any infection in your wound. You should be able to eat and drink as soon as you have got over your anaesthetic and the drip can then come down.

You may have a tube into your bladder (catheter) put in while you are in theatre. Depending on the operation you've had, this may have to stay in for up to 10 days. The catheter will drain urine from your bladder. You won't have to go to the toilet or use a bedpan and the tube will stop urine from coming into contact with your wound.

If you have had lymph nodes removed from one or both groins, you will have a tube called a drain coming out of each groin wound. This is to drain fluid that collects in the area and help to prevent swelling and infection. These drains will have to stay in until no more fluid is coming out. This can be 10 days or more with this type of surgery.

 

Your wound

You may or may not have a dressing covering your wound. Some surgeons prefer to leave the wound uncovered so that it can be regularly cleaned with warm sterile water. Your nurse will do this for you. Other surgeons like the wound to be kept covered for a few days. If you do have a dressing, your nurse will change it and clean the wound every few days at least.

If your wound is healing slowly, you may have to stay in hospital for longer than you originally thought. Or you may be able to go home and have a district nurse come in to take care of it. If you do go home, you will have to have someone there to help you manage.

The stitches used in vulval surgery are often soluble, so you don't have to have them taken out. Sometimes they don't dissolve and then do have to be removed. This won't be done until the area has healed - at least 10 days.

 

Painkillers

The vulva is a sensitive area and your wound is bound to be sore at first. There are many different types of painkilling drugs you can have. It is important to tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.

When you first wake up, you may have a pump containing painkillers attached to your drip. You may have a hand control from the pump with a button to press to give yourself extra painkillers, as you need them. This is called PCA or patient controlled analgesia. Do use it whenever you need to. You can’t overdose because the machine is set to prevent that. Do tell your nurse if you need to press the button very often. You may need a higher dose in the pump.

Some hospitals use painkillers given into the spine (an epidural) for the first day or so after surgery. These work very well. A very thin tube will be taped to your back. It will be connected to a pump that can give you a continuous dose of painkiller.

Whatever method of pain control you are having, tell your nurse if you are in pain. You may need a different type of painkiller, or a higher dose.

 

Getting over your surgery

If you have had a small operation, you should get over it quite quickly. If you have had a bigger operation, obviously it will take longer to recover. You should allow at least 6 weeks to get over it. Do bear in mind, though, that it takes longer than that for some women to recover. If it is taking you a while, you aren't doing anything wrong. Some people just heal more quickly than others. Talk to your surgeon or nurse specialist at your 6 week follow up appointment if you are at all concerned.

This is an awkward place to have surgery. You will find moving around difficult at first. It is a good idea not to walk too much for the first few weeks, as this will put a strain on the healing wound and can be painful. Keep doing the leg exercises you learned while you were in hospital to help prevent blood clots.

You may find it better to lie propped up, rather than try to sit. An air cushion can make sitting more comfortable. If you use a ring cushion, be careful to change position regularly to avoid pressure sores.

To keep the area clean and as comfortable as possible, you could try

  • Having warm baths as often as you like - don't put any perfumed bath products, soap, creams, lotions or talc on the wound area
  • Rinsing your vulval area after passing urine by pouring a jug of warm water over while you are sitting on the toilet
  • Using a hairdryer on a cold or cool setting to dry the area instead of a towel
  • Taking a stool softener, such as lactulose, to make sure you don't get constipated

Your wound will probably heal without any other problems. But if you develop oozing, a discharge that smells, heavy bleeding or have increasing pain, contact your doctor straight away. You may have an infection and need antibiotics.

There is more information on skin care in the living with vulval cancer section, including life after vulval surgery.

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Updated: 11 December 2013