Introduction/Background Selection of appropriate flap for vulval reconstruction after radical vulvectomy is a vital part of surgical armamentarium of any young gynaecological oncologist. Flap enables a tension free closure of the vulval skin which as tension on the suture line is associated with delayed healing. We describe a case of anterior hemivulvectomy for anteriorly situated lesion, closed with Pubolabial V-Y advancement flap.

Methodology Results 65 year old postmenopausal lady presented with 3x2 cm right vulval lesion within 2 cm from clitoris. Biopsy revealed the lesion to be HPV independent squamous cell carcinoma. Patient was planned for Modified Radical Vulvectomy and bilateral inguinofemoral lymphadnectomy. Anterior hemivulvectomy was done, and a defect of approximately 5 cm was present. The defect was closed using a pubolabial V-Y advancement flap. Postoperative period was uneventful. The patient received Adjuvant radiation, and is presently doing well with good quality of life.

Conclusion Pubolabial flap is an easy to learn advancement flap for beginners, especially useful in preventing urinary voiding symptoms which may be seen with anterior vulvectomy. Its use, however is limited to smaller defect size.