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.
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About 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. 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. This is usually done at a pre-assessment clinic.

Removing the area of the cancer (local excision)

If the cancer is very small, it may be possible to remove it, along with a small area of normal-looking tissue surrounding the cancer. Depending on the amount removed, this may make your vagina shorter. The vagina is naturally stretchy, so this may not be noticeable to you. But if you have difficulties with penetrative sex, talk to your specialist nurse or surgeon. They can discuss what may help.

Removing part or all of the vagina (vaginectomy)

Some women may need to have the upper part of the vagina removed (partial vaginectomy) or all of the vagina (radical vaginectomy) removed. The 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 a vaginal reconstruction means you will still be able to have penetrative sex.

Vaginectomy and hysterectomy

If the cancer has spread into surrounding tissue, your surgeon may need to remove other 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 large cut (incision) in the abdomen. Afterwards, you have a wound that goes down from the belly button to the bikini line.

  • Laparoscopic surgery 

    The surgeon operates through small cuts in the abdomen. 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.

Your surgeon will talk to you about the type of surgery you will have.

Pelvic exenteration

Occasionally, if the cancer has spread to other organs in the pelvis, the surgeon may advise more major surgery. This 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 for 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.

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, let your doctor or nurse know. 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.

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