Vulvar wide local excision, simple vulvectomy, and skinning vulvectomy
- C William Helm, MD
C William Helm, MD
- Consultant Gynaecological Oncologist
- Northern Gynaecological Oncology Centre
- Queen Elizabeth Hospital
Vulvar lesions are a common gynecologic problem. Lesions that are suspicious for malignancy or are premalignant may be excised in a conservative fashion, preserving as much of the vulvar architecture as possible. Treatment approaches also include ablative techniques, (laser, Cavitron ultrasonic surgical aspirator [CUSA]) and pharmacologic therapy .
The techniques for vulvar wide local excision and simple or skinning vulvectomy are reviewed here. Diagnosis and treatment of vulvar lesions, precancer, and cancer are discussed separately. (See "Vulvar lesions: Diagnostic evaluation" and "Vulvar intraepithelial neoplasia" and "Squamous cell carcinoma of the vulva: Staging and surgical treatment".)
INDICATIONS AND CONTRAINDICATIONS
Conservative excisional procedures are performed for selected benign or premalignant conditions of the vulva, including:
●Vulvar intraepithelial neoplasia (VIN) (see "Vulvar intraepithelial neoplasia", section on 'Excision')
●Paget disease of the vulva (see "Vulvar cancer: Epidemiology, diagnosis, histopathology, and treatment of rare histologies", section on 'Paget disease of the vulva')To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- INDICATIONS AND CONTRAINDICATIONS
- SURGICAL ANATOMY
- PREOPERATIVE EVALUATION AND PREPARATION
- Informed consent
- Prophylactic antibiotics
- Other preoperative measures
- OPERATIVE SET-UP
- WIDE LOCAL EXCISION
- SIMPLE VULVECTOMY
- - Vulvectomy
- - Closure
- Postoperative care
- SKINNING VULVECTOMY
- Postoperative care
- Recurrence of VIN after excision
- Effects on sexual function and body image
- SUMMARY AND RECOMMENDATIONS