Vaginectomy

Overview

Vaginectomy is a surgical intervention aimed at the partial or complete removal of the vagina. It is commonly undertaken by healthcare professionals to address vaginal cancer that proves unresponsive to alternative treatments. Additionally, some transgender men opt for this procedure as a component of their gender affirmation surgery.

The duration of recovery is contingent upon the extent of vaginal tissue removal and whether additional surgical procedures are necessary. It is advisable to consult your healthcare provider regarding the anticipated recovery process.

Types

The muscular tube known as the vagina is a component of the female reproductive system. It stretches from the vulva, or external genitalia, to the cervix, or uterine opening. The healthcare provider may advise the following depending on the size and location of the tumors, the cancer’s stage, and whether it has spread:

• Total vaginectomy: The complete removal of the entire vagina.
• Partial vaginectomy: The procedure will remove the top portion of the vagina.
• Radical vaginectomy: This removes the vagina in its entirety along with the surrounding tissue.

Reasons for undergoing the procedure

If a patient has vaginal cancer, they can require a vaginectomy. Usually, a healthcare provider will try alternative treatments first, which consist of chemotherapy, radiation treatment, or surgery. The healthcare provider might advise a vaginectomy if these treatments are ineffective.

Vaginectomy is a procedure used in gender affirming surgeries for certain transgender men. Female-to-male (FTM) surgery is also referred to as “bottom surgery” by the healthcare providers. Phalloplasty or metoidioplasty are typically performed prior to this treatment. A penis is being created with these operations.

Risk

Similar to any surgical procedure, complications are possible. Among them are:

• Bleeding.
• Infection.
• Issues with defecating or leaking stool.
• A vaginal fistula, which is a hole that forms between the bladder and other internal organs.
• Urinary retention.

More transgender males have made this surgical procedure their choice in recent years. Although there was formerly a greater chance of complication, the treatment is now safer than ever. Complications are now less likely to occur.

Before the procedure

Prior to surgery, your healthcare provider will conduct a thorough examination and inquire about your medical history, possibly advising you to discontinue certain medications like blood thinners and discussing the importance of quitting smoking or tobacco products due to their potential to impede healing. It is crucial to abstain from eating or drinking anything the night before the procedure, and your provider will furnish specific instructions regarding the surgery and necessary preparations.

During the procedure

During a vaginectomy procedure, typically performed under general anesthesia administered through a vein in the arm to ensure unconsciousness and pain relief, surgeons may choose either a vaginal or laparoscopic approach. The vaginal approach involves making small incisions to separate the vaginal tube from surrounding tissues, with the option to close or leave the vaginal opening. Alternatively, a laparoscopic approach uses thin instruments inserted through small abdominal incisions, bypassing the vaginal route. Additional surgeries like hysterectomy may be performed simultaneously if needed.

After a vaginectomy, some individuals consider vaginoplasty for vaginal reconstruction to facilitate vaginal intercourse. This decision is discussed with healthcare providers, who assess individual circumstances and preferences to determine the best options and timing for the procedure. It’s essential for those interested in vaginoplasty following a vaginectomy to consult with their healthcare provider to explore the possibility and implications thoroughly.

After the procedure

After undergoing the procedure, you will typically require a hospital stay lasting several days, possibly up to a week, depending on the specific type of vaginectomy and any additional surgeries performed. During your hospital stay, medical professionals will closely monitor your condition and administer pain relief medication to manage discomfort, reduce swelling, and minimize the risk of infection.

Upon discharge, your healthcare provider will provide detailed instructions on self-care and wound management. It’s crucial to adhere closely to these instructions. Physical activity should be limited for at least a few weeks, with a particular emphasis on avoiding heavy lifting or strenuous activities. Your healthcare provider will advise you on the duration of necessary rest.

Outcome

A vaginal cancer can be effectively treated with a vaginectomy. Two years after the procedure, there is a 95% survival rate for this surgery.

This treatment allows transgender males to live in a body that corresponds to their gender identity. Most transgender males who select this treatment are satisfied with the results.

The majority of transgender individuals who choose for gender affirming surgery are satisfied with the results. Studies indicate that 94% to 100% of patients report being satisfied with their results, depending on the method.
The patient should anticipate some pain within the first week or so after the procedure. Discuss with the healthcare provider the possibilities for pain management and activities they should avoid.

The duration of recovery is dependent upon the patient’s general state of health and the sort of surgery they underwent. They will most likely need to take a few weeks off from doing physical activity. This can apply to any heavy lifting, all forms of sexual engagement, and intense exercise.

Call a healthcare provider as soon as possible following this procedure if the patient developed the following:

• Abdominal swelling.
• Bleeding at the incision site.
• Signs of infection such as fever, redness, or swelling of the incision site.
• Severe abdominal pain.
• Urinary incontinence.
• Fecal incontinence.

If the patient experiences pain during intercourse and had vaginal reconstruction surgery after vaginectomy, contact their healthcare provider. Sex that hurts could indicate a fistula or other issues.