Vaginectomy

Small vaginal cancers are usually treated with radiation therapy, but in more severe cases, surgery may be needed. If you have vaginal cancer that cannot be treated with less invasive treatments, you may need to undergo a vaginectomy, or surgery to remove your vagina. 

There are three types of vaginectomies:

• Partial vaginectomy, to remove part of the vagina
• Total vaginectomy, which is surgical removal of the entire vagina
• Radical vaginectomy, to excise the entire vagina as well as surrounding tissues

If all or part of your vagina is removed, you may be able to have vaginal reconstruction, using tissue taken from another area of your body, such as your skin, intestines or muscle. Vaginal reconstruction creates a neovagina (new vagina) that allows you to have sexual intercourse after a vaginectomy.

Why is a vaginectomy performed?

Depending on the size and location of the cancer or precancer in your vagina, a vaginectomy may be recommended. Your care team will include a gynecologic oncologist, who is an expert in the diagnosis and treatment of gynecological cancers and who can determine whether surgery is necessary.

A vaginectomy is typically performed when there is:

• Large precancerous area
• Large cancerous tumor
• Cancer that has spread
• Cancer that has returned (recurrence) despite other types of treatment

Nearby organs, tissues and lymph nodes may also need to be removed when you have a vaginectomy.

How to prepare for a vaginectomy

Your care team will discuss preoperational considerations with you in advance of your surgery, including whether you should stop taking any of your medications or supplements beforehand.

It’s important to discuss any questions or concerns with your doctor before the procedure. You may want to ask whether you’re likely to have any side effects, and find out if you’re a candidate for vaginal reconstruction.

What to expect after a vaginectomy

Patients typically stay in the hospital for several days after a vaginectomy. While there, you can expect:

• The area of your surgical incision will likely be painful, but your cancer care team can help you manage the pain with medication and/or other methods.
• You may also have a urinary catheter in place for a few days to drain your urine while you recover.
• Constipation is common, but this also may be managed with fiber and/or stool softeners.
• Weakness and fatigue are normal as your body heals.

After you return home, you should take it easy and slowly resume your normal activities. It’s possible that following a vaginectomy you still may require additional cancer treatments—usually radiation therapy—to destroy any remaining cancer cells. Vaginal reconstruction may also be an option.

Vaginectomy benefits

Though the surgery is invasive, a vaginectomy is an appropriate way to treat vaginal cancer, when it’s deemed necessary and/or appropriate. Results vary based on your specific situation.

Vaginectomy risks

Common risks associated with vaginal surgery include:

• Excessive bleeding
• Increased risk of infection
• Hernia at the incision site
• Damage to internal organs

In the long term, having a vaginectomy can result in changes to your sex life.

If your lymph nodes were removed, you may experience lymphedema, or swelling and buildup of body fluid in the legs.

If you experience any of the following serious symptoms after surgery, seek medical help immediately:

• Fever of 100.4 degrees or above
• Chills
• Heart palpitations
• Chest pain
• Abnormal or excessive bleeding
• Redness or swelling around your incision or from your vagina
• Fluid from the incision or vagina
• Torn incision
• Difficulty urinating
• Foul-smelling urine
• Nausea and/or vomiting
• Extreme constipation or diarrhea
• Blood in your urine or bleeding from your rectum
• Signs of infection in your arm or leg (pain, redness, swelling and/or warmth)