Cancer Care For Women

Post Operative Instructions

Discharge Instructions: Radical Vulvectomy 
This guide will help you in your recovery at home. When you get home, call your doctor (gynecology oncologist) to make an appointment for a checkup in 2 weeks. At this 2 week check up you will learn the results of the tissue samples (biopsies) and your follow up plan of care.

When to Call the Doctor
You should call your doctor if you have any of the following:

• Fever more than 101 F by mouth
• Shaking chills
• Trouble breathing
• Upset stomach or vomiting
• Loose stools or diarrhea
• Pain or foul odor when passing urine
• Foul odor from vaginal drainage
• Warmth, drainage, hardness, or bleeding from your suture line
• New bruising or opening of your suture line

Call (207) 761-0125 or toll-free 1-877-277-4331. You will speak to a resident doctor if you call after office hours.

Bathing
You may shower. You may also take tub baths if your feet are first washed and are clean (using other water and a washcloth). Take a sitz bath 2-3 times each day. After passing urine and after each bowel movement, rinse the skin with a full squeeze bottle of warm tap water then pat dry.

Suture Line Care
Look at your suture line at least once a day to see how it is healing. Clean the suture line with water during your shower or bath. The sutures will dissolve on their own.

Ostomy Care
If you have an ostomy, a special nurse with stoma care skills (Enterostomal Therapy Nurse) will work with you, your family and home health nurse as needed, to help you to learn the care you need to do.

Activities

1. Stairs - Plan to climb as tolerated.
2. Driving - Do not drive a car for at least 2 weeks. If you ride in the car, plan to stop and stretch at least every 2 hours. When your doctor feels you may start to drive, try to practice in the driveway first. You need to know if your abdomen and leg muscles can react well. Have someone with you until you feel you have healed and you can drive safely.
3. Lifting - Do not lift heavy objects which would make you strain. Lift no more than 10 pounds (such as a 10-pound bag of sugar). Lift slowly and use good body posture to prevent strain.
4. Sex - Do not put anything in your vagina for 6 weeks. When you do have sex, be slow and gentle and use a lubricant (such as Replens, Astroglide or KY jelly). Stop when you feel pain or see blood. Call your doctor if you have extreme pain or bleeding.
5. Exercise - Gentle stretching and walking as tolerated are encouraged and are acceptable.

Comfort

• Keep the suture (perineal) area clean, dry and open to air as much as possible. Use a sitz bath and then dry with a soft cotton cloth or hair dryer set on the "air" or "cool" setting.
• When lying on your side, use a pillow between your knees so air will flow through.
• Wear cotton under pants, loose cotton jogging pants, or skirts.
• Do not cross your legs when sitting or lying down

If you have any questions about your recovery, talk to your doctor or nurse practitioner.

Your Provider can help you with:

1. "Change of life" or menopause symptoms (hot flashes, mood changes, trouble with sleep, or vaginal dryness)
2. Feeling depressed for more than 2 weeks
3. Relaxation techniques 
4. Pelvic muscle exercises
5. Sexuality and sexual questions
6. Treatment education 
7. Wig prescriptions (if you have chemotherapy which may cause hair loss)
8. Return to work plans and forms