The consequences of curative surgery can be psychologically devastating, as vulvar surgery can result in lifelong anatomic alterations.
Sexual dysfunction is common because of loss of clitoris in some clinical situations and in general because of alteration in body image.
Lower extremity lymphedema (leg swelling) can occur, causing difficulty walking, pain, recurrent infections and disfigurement.
Therefore, all therapy includes pretreatment counseling about sexual and physical function.
If the cancer has spread outside the vulva and the other female organs, the doctor may take out the lower colon, rectum or bladder (depending on where the cancer has spread), along with the cervix, uterus and vagina (pelvic exenteration).
Physicians have developed ways for patients to store and eliminate wastes after these procedures, and it is sometimes possible to reconstruct or reattach these organs so no external appliances are needed.
A patient may need to have skin from another part of the body added (grafted) and plastic surgery to make an artificial vulva or vagina after these operations.
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