ABSTRACT
In the 1920s, Victor Bonney (1920) continued the tradition of radical vulvectomy and groin node dissection in British patients. However, it was Stoekel, working initially in Munich, and later in Berlin, who demonstrated the need for individualization of surgical treatment. Stoekel, in his seminal monograph of 1930, outlined every known variant of surgical treatment, many of which have later been “rediscovered” by other experts around the world. Closer to home, Stanley Way, working in Gateshead in the 1940s, re-confirmed the importance of the lymphatic ray and the drainage of the vulva, and suggested that a wide local excision of the lesion on the vulva should be combined with an extensive dissection of the skin of the suprapubic area and the groin ( Way 1948 ). Unfortunately, although the cure rates for cancer of the vulva improved markedly when radical treatment was adopted, the adverse effects of such massive surgery were that patients spent a considerable time in hospital and were left with large wounds requiring intensive nursing care. Interestingly, the long-term result of these large wounds was frequently a remarkably satisfactory cosmetic effect.
