Anatomical reconstruction after vulvectomy.

Abstract

Vulvectomy is a disfiguring operation detrimental to self-esteem and female identity, but surgical techniques for anatomical reconstruction are not routinely performed. Anatomical reconstruction of the vulva is illustrated in 1) a patient with superficial vulvectomy, 2) a patient with deep anterior vulvectomy, and 3) a patient with extended radical vulvectomy. Random skin flaps and axial-pattern skin flaps based on the deep external and the internal pudendal arteries were used. All patients had good postoperative results. Established reconstructive procedures can be used to restore the labial folds, vestibulum, posterior commissure, and perineum. We advocate reconstruction of the anterior commissure with clitoral protrusion after superficial and deep vulvectomy.