Surgery for vaginal cancer
There are different types of surgery for vaginal cancer depending on the stage and where the cancer is in the vagina.
- where the cancer is in the vagina
- how far it has grown.
Before the operation, your surgeon and specialist nurse will explain what it involves. You may need some tests before surgery to make sure you are well enough. These are usually done at a pre-assessment clinic.
Some people may need to have the upper part of the vagina removed (partial vaginectomy), or all of the vagina removed (radical vaginectomy). Your surgeon may make a new vagina (vaginal reconstruction) using tissue from other parts of the body. They sometimes do this at the same time as the vaginectomy. Sometimes it is better to do this as a second operation at a later date. Having vaginal reconstruction means you may be able to have penetrative sex.
If the cancer has spread into surrounding tissue, your surgeon may need to remove some other nearby organs as well as the vagina. They may advise removing:
- the womb (this is called a hysterectomy)
- the ovaries
- fallopian tubes
- nearby lymph nodes.
This surgery can be done in different ways:
The surgeon makes one cut (incision) in the abdomen (tummy). Afterwards, you have a wound that goes across your tummy just above the hips, or that goes down from the belly button to just above the hips.
The surgeon operates through small cuts in the tummy. They use small surgical instruments and a flexible, thin telescope with a video camera on the end (laparoscope). The laparoscope lets the surgeon see inside the body.
This is like laparoscopic surgery, but the laparoscope and instruments are attached to robotic arms. The surgeon controls the robotic arms.
Sometimes, if the cancer has spread to other organs in the pelvis, the surgeon may advise more major surgery. It is also sometimes used if the cancer comes back after radiotherapy.
This type of surgery involves removing part of the bowel or the bladder, or both, as well as the vagina, womb and ovaries. This is called pelvic exenteration. It is major surgery and is only suitable if there are no signs of cancer anywhere else. You also need to be well enough to cope with it.
How long you are in hospital will depend on the type of operation you have. After your operation, the nurses will encourage you to start moving around as soon as possible. This helps prevent complications, such as a blood clot or chest infection. We have information on recovery from surgery.
Your nurse will give you elastic stockings (TED stockings) to help prevent blood clots in the legs. They may ask you to wear them for a few weeks after you go home. You may also have daily injections of a blood-thinning drug.
It is normal to have some pain or discomfort for a few days. The nurses will make sure you have regular painkillers. If the pain is not controlled, tell your doctor or nurse. They can change your painkillers or increase the dose.
It takes time to recover from surgery and you may feel tired for several weeks. If you have had a hysterectomy, you will need to avoid heavy lifting for at least 12 weeks. Your doctor or nurse will give you advice about your recovery.
Below is a sample of the sources used in our vaginal cancer information. If you would like more information about the sources we use, please contact us at email@example.com
Adams T, Cuello M. Cancer of the Vagina: FIGO cancer report 2018. International journal of gynaecology and obstetrics. p14-21.
Royal College of Radiotherapy: Clinical Oncology. Radiotherapy dose fractionation, third edition. 2019.
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