The side effects of surgery depend on the type of operation you have had.
Usually, the smaller the operation, the fewer the side effects. All surgery can cause immediate side effects, such as pain. Other possible side effects are infection and blood clots.
Scar tissue can form following surgery to the vagina. Scar tissue is more fibrous than healthy tissue so it’s stiffer and less stretchy.
Scar tissue might form around the outside of the vagina and narrow the entrance. This might apply to women who have not had their vagina removed, or have had part of their vagina removed. You might find that penetrative sex can be painful because of the narrowing.
To prevent narrowing, your specialist nurse will teach you to stretch the vaginal opening with dilators. You might also need to use dilators if you have a vaginal reconstruction.
Dilators are smooth cone shaped objects that you put into your vagina to stretch it. They come in sets of different sizes. You start using them once the area has healed after surgery. You use them every day for a few minutes with a water soluble lubricating gel.
You begin with a comfortable size dilator and use larger ones until your vagina is stretched enough for you to have sex comfortably. Some people like to involve their partner with this.
Contact your specialist nurse or doctor if you have any problems or questions. A surgeon can sometimes use skin grafts to widen the vaginal opening, if dilators have not worked.
Difficulty having an orgasm
Women who have had their lower vagina removed might have a reduction in sexual desire. They may have less pleasure during sex and problems reaching orgasm.
This doesn’t always happen, it depends on the exact position and size of the cancer. You will need to discuss this with your surgeon. They will explain as much as possible before the operation.
Your surgeon might not be able to tell you exactly the type of surgery you are going to have before your operation. They also might not be able to say how the surgery will affect your sensations during sex.
There are sex therapists you can see if you would like to. Talk to your GP or specialist nurse. They can put you in touch with a therapist.
Leg and groin swelling
Depending on the type of operation you have, you might need to have the lymph nodes removed in your groin. This can sometimes cause swelling between your legs or down your thighs. This is called lymphoedema. The swelling can make your leg feel heavy and it can be painful and tiring. It might affect one leg or both legs.
Lymphoedema can come on years after your treatment. Any trauma, such as cuts and infections, can increase the risk of lymphoedema developing. So try to avoid this happening by looking after your legs.
- Protect your legs and feet from sharp objects – always wear shoes, and wear long trousers for gardening.
- Wear insect repellent so that you don't get bitten.
- Take care of all cuts, scratches or bites straight away by cleaning them with antiseptic and covering with a dressing.
- Avoid sunburn.
- Take extra care when cutting your toenails – you should not cut or tear the cuticles.
- Use an electric razor carefully if you shave your legs.
If you notice any swelling, tell your doctor or specialist nurse straight away. Lymphoedema is easier to control if it is caught early. They can refer you to a lymphoedema specialist for assessment. The specialist is usually a nurse or physiotherapist.
Ways to manage lymphoedema
The lymphoedema specialist might try different treatments to manage your lymphoedema. These include:
- specially fitted support stockings
- compression bandaging
- a type of massage called manual lymphatic drainage (MLD)
- an inflatable sleeve that gently squeezes fluid towards the top of your legs to drain it away through the lymphatic vessels
These treatments should only be carried out by someone with specialist training.
Bowel or bladder problems
Some women who have surgery for vaginal cancer have problems afterwards with their bladder or bowel. This depends on the type of surgery and varies from person to person.
Ask your surgeon if your operation is likely to affect how your bowel or bladder work. Let your doctor or specialist nurse know if you have any problems after surgery.