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Having your operation for vaginal cancer

Women discussing vaginal cancer

This page is about what happens when you have surgery for vaginal cancer.

 

A quick guide to what's on this page

Having your operation for vaginal cancer

When you go into hospital, your surgeon, anaesthetist, physiotherapist and nurse will all come and talk to you. Your surgeon will explain what will happen during the surgery and what to expect afterwards. Ask as many questions as you need to. It may help to make a list of questions beforehand. You may have blood tests or X-rays.

Immediately after your operation

Operations to remove a vaginal cancer (wide local excision), or to remove the vagina or nearby organs can be major surgery. After the operation you may have several different tubes in place. You will have a drip to give you fluids. You may have a tube in your nose to drain fluid from your stomach and stop you feeling sick. You may have drains coming out of any wounds, and a tube into your bladder (a catheter). You may also have a urostomy bag if you have had your bladder removed, or a colostomy bag if you have had part of your bowel removed.

You will almost certainly have pain for the first week or so. It is important to tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you.

Making progress

After removal of the vagina, or other pelvic organs you will need to rest for at least a month after you come out of hospital. During this time, you will not be able to do heavy lifting, carry heavy bags, or drive. Vaginal cancer surgery can have a big impact on your feelings and emotions. It is important to keep active, for example with regular exercise. You are likely to have times when you feel very down and this is natural. You can get support from your doctors and nurses, family and friends.

 

CR PDF Icon You can view and print the quick guides for all the pages in the treating vaginal cancer section.

 

 

Before your operation

You will have

  • Blood tests to check your general health, and your liver and kidney function
  • A chest X-ray to check your lungs are healthy
  • A test called an electrocardiogram (ECG) to check your heart is healthy

You may have had some of these tests when your cancer was diagnosed. If so, you may not have to repeat them. You may also have

  • A heart test called an echocardiogram
  • Breathing tests called lung function tests
  • An electrocardiogram (ECG) while you are exercising

These tests are to make sure that you are fit enough to make a good recovery from your surgery.

A physiotherapist may teach you breathing and leg exercises. You can help yourself to get better by doing these exercises after your operation. You should do them as often as you are told you need to.

Breathing exercises will help to stop you getting a chest infection. Leg exercises will help to stop clots forming in your legs. Both these complications of surgery can happen when you are not moving around as much as you would normally. Your nurses will encourage you to get up and about as soon as possible after your operation.

Below is a short video showing breathing and circulation exercises after surgery. Click on the arrow to watch it.
 


 

View a transcript of the video showing breathing and circulation exercises after surgery (this opens in a new window).

When you go into hospital for your operation, your surgeon, anaesthetist, and a specialist nurse will all come and talk to you. Your surgeon will explain what is going to happen during the surgery and what to expect when you come round from the anaesthetic. Ask as many questions as you need to. It may help to make a list of questions before you go into hospital. There are some suggestions for questions at the end of this section. The more you know about what is going to happen, the less frightening it will seem. Don’t worry if you think of more questions later. Your specialist nurse can answer questions. And your doctor can come back to see you again if necessary.

Your pubic hair may need to be shaved before your operation. You may be able to do this yourself on the ward. Or your nurse may do it in the operating theatre while you are under anaesthetic.

 

Immediately after your operation

When you wake up, depending on the operation that you've had, you may have several different tubes in place. This can be a bit frightening. But it helps to know what they are all for. You may have

  • Drips (intravenous infusions) to give you blood transfusions and fluids until you are eating and drinking again
  • A nasogastric tube to drain fluid from your stomach and to stop you feeling sick
  • One or more drains coming out of any wounds
  • A tube into your bladder (catheter) to drain urine and monitor your urine output
  • A urostomy bag if you have had your bladder removed
  • A colostomy bag if you have had part of your bowel removed

The wound drains stop blood and tissue fluid collecting around the operation site. This helps your wound to heal and helps to stop infection. The wound drains connect to suction bottles, which your nurse will empty every day. The drains can come out when no more fluid drains out of them.

If your surgeon has removed lymph nodes from one or both of your groins, you may also have drains coming out of each groin wound. These drain tissue fluid and help to prevent swelling and infection.

When you first wake up, you will have a little clip on your finger to measure your pulse and blood oxygen levels. This is called a pulse oximeter. You may have an oxygen mask on for a while. You will also have a blood pressure cuff on your arm. Your nurse will check your blood pressure often for the first few hours after you come round from the anaesthetic. Your urine output will also be monitored because it can help show whether you have too much fluid or are getting dehydrated.

You may have a couple of electronic pumps attached to your drips. The pumps are for controlling any medicines you might need to have through your drip.

Because you have had major surgery and an anaesthetic, you may feel a bit confused when you wake up on the ward. This can be frightening and may make you feel as if you have no control over things. The staff will be very aware of this and will visit you often to see if you need anything. You will have a call bell close by, so that you can call for help whenever you need it.

 

Painkillers

If you have had a big operation then you will almost certainly have pain for the first week or so. There are many different painkillers you can have. It is important to tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly, so take them as often as you are advised to.

Many hospitals now use electric pumps for painkillers after surgery. These attach to your drip. You have a hand control with a button to press to give yourself extra painkillers as you need them. This is called PCA or patient controlled analgesia. Do use it whenever you need to. You can’t overdose because the machine is set to prevent that. Tell your nurse if you need to press the button very often. You may need to have a higher dose in the pump.

For some operations your anaesthetist may set up a spinal anaesthetic (epidural) to give painkillers into the fluid around your spinal cord. This makes your body numb from the waist down.

You can read more about painkillers  and spinal anaesthetic

 

Eating and drinking

When you wake up you may not be able to eat or drink anything for a while. This depends on the type of surgery you have had. As soon as you are fully awake, you can wet your mouth with sips of water. Gradually the amount you are allowed to drink will increase. Once you can drink without being sick, your drip and nasogastric tube can come out. You will then be able to start on a light diet.

If you have had a wide local excision you may be able to eat and drink later that day. If you have had a vaginectomy or hysterectomy, you will probably be able to eat and drink again within a day. If you've had more extensive surgery, involving your bowel and bladder, it may be a bit longer before you can eat properly again.

You can read more about the different types of surgery for cancer of the vagina

 

Your wound

If you are having surgery for the earliest stage of vaginal cancer you may just have a wound inside your vagina, where the surgeon has removed the area containing the cancer cells.

If your cancer is in the lower third of your vagina, your surgeon may also remove part of the external genital area – the lips of the vagina (the vulva).

If you have the whole vagina removed (a radical vaginectomy), you may also have a scar down the centre of your abdomen. Talk to your surgeon about whether you will have an abdominal scar. Treatment for vaginal cancer is very individual and depends on the exact size and position of the tumour.

If you have had a radical hysterectomy, you may have quite a long scar down the centre of your abdomen (vertically). 

For any vaginal cancer surgery, you may have lymph nodes removed from your groin area. So you will have wounds in these areas too.

Any external wound from the operation will be covered up with a dressing when you come round. It will be left covered for a couple of days. After a couple of days your nurse will change the dressings and clean the wound. They will change the bottles attached to your wound drains every day. The drains stay in until no more fluid is coming out. This may be 10 days or more after surgery to remove lymph nodes.

Any stitches or wound clips will stay in for up to 10 days. You may have them taken out before you go home. But sometimes, if you feel well, but the wound is not quite healed, you can go home with stitches in. You may then have to go back to the hospital to have your stitches out. Or a district nurse may visit you at home and take them out there. If you have internal wounds, the stitches will dissolve by themselves once the wound has healed.

You can read more about the different types of surgery for cancer of the vagina.

 

Getting up

Getting up may seem very difficult at first. Moving about helps you to get better, but you will need to start very gradually. Walking is likely to feel strange at first, if you have dressings in your groin or between your legs. But it will get easier. Your physiotherapist may visit you every day after your operation to help you with your breathing and leg exercises.

Your nurses will encourage you to get out of bed and sit in a chair one or two days after your surgery. They will help you with any drips and drains. Over the next couple of days, the tubes, bottles and bags will be taken away. Then, it will be much easier to get around.

 

Making progress

After a few days, you will be up and about more. Gradually you will start to feel better. If you have had major abdominal surgery, you may find it easier to have frequent, small meals at first, rather than 3 large meals a day. The hospital dietician may give you help and advice with managing your diet. If you have had a colostomy or urostomy, the stoma nurse will help you learn to manage your bag.

After this type of abdominal surgery, you will need to rest at home for at least a month after you come out of hospital. The first outpatient appointment is usually about 6 weeks after the operation date. Until this time, you will not be able to

  • Do anything that puts strain on your abdomen (such as vacuuming)
  • Do any heavy lifting
  • Drive

All these activities put pressure on your abdominal muscles and skin. The abdominal wounds need time to heal. It will take longer to get over your operation if you put too much strain on the area so it is good to rest at first. You will gradually be able to increase the amount you do. A short walk every day is a good idea. You will get a bit of fresh air, and you can gradually go further as you get your strength back. Do take it easy at first though. Remember that however far you walk, you have to cover the same distance to get back home.

 

Emotional effects of vaginal surgery

Vaginal cancer surgery can have a big impact on your feelings and emotions. You are likely to have times when you feel very down and this is natural. You can get support from your doctors and nurses, family and friends. If you would like to talk to someone outside your own friends and family, you can look for people who can help on our vaginal cancer organisations page. You can also find details of counselling organisations.

If you want to find people to share experiences with on line, you could use CancerChat, our online forum. Or go through My Wavelength. This is a free service that aims to put people with similar medical conditions in touch with each other.

There is information about living with cancer of the vagina in this section.

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Updated: 23 September 2015