Operative Morbidity & Mortality

The most frequently encountered complication is wound breakdown, which occurs in well over 50% of patients undergoing radical vulvectomy and bilateral inguinal dissection. This complication is related to the amount of skin removed during the procedure, particularly at the groin areas.

Separate groin incisions and careful handling of skin flaps have reduced the incidence of wound breakdown. Vigorous wound care with debridement almost always results in adequate healing.

Lymphedema occurs in approximately 65% of patients who have had radical vulvectomy. Hemorrhage, lymphocyst formation, thromboembolic disease, urinary tract infections, and sexual dysfunction are other commonly associated morbidities.

Follow-Up

After the immediate postoperative period, patients should be examined every 3 months for 2 years and every 6 months thereafter to detect recurrent disease or a second primary cancer. Nearly 80% of recurrent vulvar cancer occurs in the first 2 years. Treatment modalities depend on the location of recurrence. Malignant melanomas and sarcomas may recur locally or metastasize to the liver or lungs.