Surgery is an effective treatment for vaginal cancer. Generally, patients with small lesions in the upper vagina are the best candidates for surgery. Part or all of the vagina may be surgically removed. Our surgeons consider your medical history, stage of cancer and current health condition to determine the type of surgery that’s most appropriate for you.
Our gynecologic surgeons employ minimally invasive techniques such as robotic-assisted surgery as the standard of care for treating gynecologic cancers. Complex vaginal cancer surgery is available through the specialists at the Penn Center for Advanced Gynecologic Surgery.
Surgery for vaginal cancer
Hysterectomy for vaginal cancer
For some types of vaginal cancer, surgeons remove the uterus and the cervix in a procedure known as a hysterectomy. A hysterectomy may be performed as an open procedure, known as an abdominal hysterectomy, in which the uterus is removed through an incision in the abdomen. If lymph node sampling is needed, this can be done through the same incision as the abdominal hysterectomy.
When the uterus is removed through the vagina, it is called a vaginal hysterectomy. Often done as a minimally invasive procedure using a laparoscope, a thin camera inserted into the abdomen to facilitate the procedure, the vagina and any lymph nodes can be removed.
Simple hysterectomy for vaginal cancer
A simple hysterectomy leaves the loose connective tissue around the uterus (parametrium), the tissue connecting the uterus and sacrum (uterosacral ligaments) and the vagina intact. Removing the ovaries and fallopian tubes is a separate procedure and are often performed along with a hysterectomy.
Radical hysterectomy for vaginal cancer
In a radical hysterectomy, the entire uterus, the tissues next to the uterus (parametrium and uterosacral ligaments) and the upper part of the vagina are removed.
A radical hysterectomy is usually performed abdominally, but can also be performed through the vagina. Most patients undergoing a radical hysterectomy also have a lymph node dissection, in which lymph nodes are removed either through the abdominal incision or by laparoscopic lymph node sampling. The lymph nodes are then checked by a pathologist to determine whether cancer has spread from the vagina to other parts of the body.
Oophorectomy
An oophorectomy is a procedure in which both ovaries are removed.
Pelvic exenteration
Pelvic exenteration is a radical surgery that removes all organs from the pelvic region. It is not commonly performed by Penn Medicine gynecologic oncologists, but may be used to treat cancer that has spread to surrounding reproductive and pelvic organs.
Vaginectomy
In a vaginectomy, the surgeon removes the vagina and usually some pelvic lymph nodes. A plastic surgeon can create a new vagina with grafts of tissue from other parts of the body.