Luigi Frigerio

In “Clinical Problems, Injuries and Complications of Gynecologic and Obstetric Surgery. Third Edition
Ed. by D.H. Nichols and J.O. DeLancey.pp.349-353. Williams &Wilkins. Baltimore.1995
(In coll.con  A. Ferrari)

Summary: Two cases of Vulvar carcinoma with coexistent genital prolapse are described. In the first case radical vulvectomy combined with en bloc dissection of the groin lymphatics and retroperitoneal limphadenectomy was performed for FIGO stage III lesion (T2 N1 M0). Vaginal hysterectomy, Mc Call culdoplasty and anterior colporrhaphy were combined with pobourethral plication for the correction of moderate stress incontinence. Bilateral skin flap transposition from the internal thigh was employed to correct the perineal defect. She received 5000 cGy of pelvic and groin irradiation. Sixty months after diagnosis the patient remained without evidence of recurrent disease. She was still continent with good vaginal vault suspension in spite of moderate cystocele (first degree). In the second case Modified radical vulvectomy with bilateral inguinal lymphadenectomy was performed by different inguinal incisions to treat T2 N0 M0 lesion. Genuine stress incontinence was corrected using a modified Raz procedure with four-corner bladder and urethral suspension. Urinary retention was treated by Foley catheterization until spontaneous micturition (26 days after operation). The patient was still alive 36 months after surgery, but complained of slight urge incontinence in the morning.