Vulvectomy

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Vulvectomy
Intervention
ICD-9-CM 71.5-71.6

Vulvectomy refers to a gynecological procedure in which the vulva is partly or completely removed. The procedure is usually performed as a last resort in certain cases of cancer,[1] vulvar dysplasia, vulvar intraepithelial neoplasia,[2] human papillomavirus or female genital mutilation. Although there may be severe pain in the groin area after the procedure, for a number of weeks, sexual function is generally still possible but limited.[3]

Types[edit]

A simple vulvectomy means removal of all external tissue, while a radical vulvectomy is the same however, also includes the removal of the clitoris, lymph nodes and nearby tissue.

A partial vulvectomy is the least severe, only removing the affected portion of the vulva.

'Skinning vulvectomy' involves the removal of the top layer of vulvar skin (the external female genital organs, including the clitoris, vaginal lips and the opening of the vagina). In this case skin grafts from other parts of the body may be needed to cover the area. There are two types of Skinning Vulvectomy, the 'partial skinning vulvectomy' and the 'total skinning vulvectomy'. The objective of the first one is the preservation of the cosmetic and functional integrity of the vulva in younger and sexually active patients, in whom a steady increase in the incidence of vulvar intraepithelial neoplasia has been observed in the last decade. Meanwhile, the objective of the total skinning vulvectomy is to remove the entire vulva with total skin graft replacement in patients with an entire vulvar cancer involvement. 'Modified radical vulvectomy' involves the removal of vulva containing cancer and some of the normal tissue around it.

References[edit]

  1. ^ Fuh KC and Berek JS (2012) Current management of vulvar cancer. Hematol Oncol Clin North Am. 26(1):45-62.
  2. ^ Hillemans P, Wang X, Staehle S, Michels W, Dannecker C (2006) Evaluation of different treatment modalities for vulvar intraepithelial neoplasia (VIN): CO(2) laser vaporization, photodynamic therapy, excision and vulvectomy. Gynecol Oncol. 100:271-5.
  3. ^ Aerts L et al (2012) Sexual, psychological, and relational functioning in women after surgical treatment for vulvar malignancy: a literature review. J Sex Med. 9(2):361-71.