Surgery for vaginal cancer

Surgery for vaginal cancer is usually only used for small stage 1 cancers and for cancers that were not cured by radiotherapy.

About 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.

Surgery for vaginal cancer is usually only used for small stage 1 cancers and for cancers that were not cured by radiotherapy. The type of operation you have will depend on:

  • 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.

Removing part or all of the vagina (vaginectomy)

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.

Vaginectomy and hysterectomy

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:

  • Abdominal surgery

    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.

  • Laparoscopic surgery

    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.

  • Robotic surgery

    This is like laparoscopic surgery, but the laparoscope and instruments are attached to robotic arms. The surgeon controls the robotic arms.

Pelvic exenteration

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.

After your operation

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.

About our information

  • References

    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 cancerinformationteam@macmillan.org.uk

    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.

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected. Our aims are for our information to be as clear and relevant as possible for everyone.

You can read more about how we produce our information here.