Vaginectomy

What is vaginectomy?

Vaginectomy is a procedure to remove all or part of your vagina.

You may need a vaginectomy if you have vaginal cancer. Your provider usually tries other treatments first. These may include radiation therapy, surgery or chemotherapy. If those treatments don’t work, your provider may recommend vaginectomy.

Depending on the location and size of the cancer, the stage of cancer and whether it has spread, your provider may recommend:

• Partial vaginectomy (removes the upper portion of your vagina only)
• Total vaginectomy (removes your entire vagina)
• Radical vaginectomy (removes your entire vagina and the tissue or organs around it)

This procedure is relatively uncommon. Providers can usually treat vaginal cancer with radiation and surgery to remove just the cancer. So, vaginectomy isn’t often necessary.

How should I prepare for vaginectomy?

Your healthcare provider will tell you how to prepare for surgery. They’ll also give you instructions about:

• When to stop eating and drinking
• When to adjust or stop certain medications
• Stopping smoking or using nicotine products
• What to wear to your procedure
• Planning for a hospital stay
• Planning for help at home after surgery

What happens during the procedure?

Your provider will give you general anesthesia through a vein in your arm. This medicine will put you to sleep so you don’t feel pain. There are two main ways to perform a vaginectomy:

• Transvaginal: Your surgeon performs the surgery through your vaginal opening. They don’t make any incisions (cuts) on the outside of your body. Instead, they separate your vagina from the tissues surrounding it and remove the tissue through your vaginal opening. Depending on the technique, your provider may close off your vaginal opening.
• Laparoscopically: Instead of going through your vagina, your surgeon makes a few small incisions in your abdomen. They insert a long, thin instrument with a camera on the end through one of those incisions. They usually inflate your abdomen with carbon dioxide so they can better see your pelvic organs. Then, they remove all or part of your vagina either through the abdominal incisions or through your vaginal opening.

After a vaginectomy, you may choose to have a vaginoplasty. This is surgery to create a vagina so that you can have vaginal intercourse. If you’re interested in this procedure, talk to your provider. They’ll discuss your options, including when to get this surgery.

How long does it take?

It can take up to two hours, but it depends on the type you have. Ask your surgeon what you can expect.

What are the benefits and risks?

The main benefit is that it can treat vaginal cancer when other methods don’t work.

As with any surgery, there’s a risk of complications. They include:

• Excessive bleeding
• Infection
• Leaking poop or being unable to hold your poop
• Vaginal fistula
• Not being able to empty your bladder

What happens after vaginectomy?

You’ll need to stay in the hospital after the procedure. How long you stay depends on the type of vaginectomy you had. While you’re in the hospital, your provider will monitor you and give you medications to relieve pain and lower the risk of infection.

When you’re able to go home, your provider will tell you how to care for yourself and how to take care of your incisions. Follow your provider’s instructions carefully. You should limit physical activity for at least a few weeks and give yourself plenty of time to rest.

What is the recovery time?

You can expect to have some pain in the first week or so after surgery. Talk to your provider about your pain relief options and which activities to avoid.

Recovery time varies depending on how much of your vagina your provider needs to remove and whether you need other surgeries, too. You’ll probably need to avoid physical activity for several weeks. This includes intense exercise, all sexual activity and any heavy lifting.

When should I see my healthcare provider?

After this procedure, call your provider right away if you have:

• Excessive bleeding
• Swelling in your abdominal area
• Fever, redness and swelling near the incision (these are signs of infection)
• Severe abdominal pain
• Difficulties peeing or pooping normally