Atlas of pelvic gynecologic surgery free download pdf

If a lymph node near a vulvar cancer is abnormally large, it's more likely to contain cancer and a sentinel lymph node biopsy is usually not done. Instead, a fine needle aspiration FNA biopsy or surgical biopsy of that lymph node is done to check for cancer cells. Removal of wide areas of vulvar skin often leads to problems with wound healing, wound infections, or failure of the skin graft to take.

The more tissue removed, the greater the risk of these complications. Good hygiene and careful wound care are important. The urine stream might go to one side because tissue on one or both sides of the urethral opening has been removed.

Other complications of vulvar and groin node surgery include formation of fluid-filled cysts near the surgical wounds, blood clots that may travel to the lungs, urinary infections, and reduction of sexual desire or pleasure. After vulvar surgery, women often feel discomfort if they wear tight slacks or jeans because the "padding" around the urethral opening and vaginal entrance is gone.

The area around the vagina also looks very different. Lymphedema: Removal of groin lymph nodes lymphadenectomy can result in poor fluid drainage from the legs. This is called lymphedema. The risk of this is higher if radiation is given after surgery. Information about lymphedema and how to manage it can be found in Lymphedema. Sexual impact of vulvectomy: Women often fear their partners will feel turned off by the scarring and loss of the outer genitals, especially during oral sex.

Some women may be able to have surgery to rebuild the outer and inner lips of the genitals. It may be difficult for women who have had a vulvectomy to reach orgasm. The outer genitals, especially the clitoris, are important in a woman's sexual pleasure. For many women, the vagina is just not as sensitive. Women may also notice numbness in their genital area after a radical vulvectomy, but feeling might return over the next few months as nerves slowly heal. When touching the area around the vagina, and especially the urethra, a light caress and the use of a lubricant can help prevent painful irritation.

If scar tissue narrows the entrance to the vagina, penetration may be painful. Vaginal dilators can sometimes help stretch the opening. When scarring is severe, the surgeon can sometimes use skin grafts to widen the entrance. Sometimes, a special type of physical therapy called pelvic floor therapy may help.

Lymphedema resulting from removal of lymph nodes in the groin area can cause pain and fatigue. This also can be a problem during sex. A couple will need to use good communication to cope with such problems. Save my name, email, and website in this browser for the next time I comment. About the Author: Barbara L. Lisa M. Leave a Reply Cancel reply Your email address will not be published. MRI scans may also help find enlarged lymph nodes with a special technique that uses very tiny particles of iron oxide.

These are given into a vein and settle into lymph nodes where they can be spotted by MRI. In this test radioactive glucose sugar is given to look for cancer cells. Because cancers use glucose sugar at a higher rate than normal tissues, the radioactivity will tend to collect in the cancer.

A scanner can spot the radioactive deposits. This test can be helpful for spotting small collections of cancer cells. PET scans are not a routine part of the work-up of early endometrial cancer, but may be used for more advanced cases. If a woman has problems that suggest the cancer has spread to the bladder or rectum, the inside of these organs will probably be looked at through a lighted tube.

In cystoscopy the tube is put into the bladder through the urethra. In proctoscopy the tube is put in the rectum. These exams allow the doctor to look for cancer. Small tissue samples can also be removed during these procedures for testing. They can be done using a local anesthetic but some patients may need general anesthesia. Your doctor will let you know what to expect before and after these tests.

These procedures were used a lot in the past, but now are rarely part of the work up for endometrial cancer. The complete blood count CBC is a test that measures different cells in the blood, such as the red blood cells, the white blood cells, and the platelets.

Endometrial cancer can cause bleeding, which can lead to low red blood cell counts anemia. CA is a substance released into the bloodstream by many, but not all, endometrial and ovarian cancers.

If a woman has endometrial cancer, a very high blood CA level suggests that the cancer has likely spread beyond the uterus. Some doctors check CA levels before surgery or other treatment.

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