Colpectomy (removal of the vagina)
What does a colpectomy (removal of the vagina) involve? How do you prepare for the operation? Below you can read about the procedure, the risks involved and the recovery period following a colpectomy.
Removal of reproductive organs
You might want to have your female reproductive organs completely or partially removed. There are a number of reasons for this, for example, you may wish to undergo a metoidioplasty or phalloplasty (with urethral lengthening) in the future or you may be experiencing dysphoria.
Both the complete and partial removal of the female reproductive organs have direct consequences for your fertility and your ability to have children. It is therefore important to find out as much as possible about the options for preserving fertility.
You can have several female reproductive organs removed. The various gynaecological operations are listed below:
- Removal of the uterus (hysterectomy)
- Removal of the vagina (colpectomy)
- Removal of the ovaries (oophorectomy)
- Removal of the fallopian tubes (salpingectomy )
These operations can be carried out in various combinations. In addition, some of these operations can be combined with the removal of the breasts (mastectomy).
The different operations and combinations have varying effects on your hormone balance, fertility, and ability to become pregnant and carry a child. There are also different risks of medical problems (complications). It is therefore important that you carefully consider which organs you wish to have removed and what would be a sensible combination for you.
You should also discuss this with your gynaecologist. If you wish to undergo a metoidioplasty or phalloplasty without urethral lengthening, you do not need to have your female reproductive organs removed. If you do wish to have urethral lengthening, it is necessary to have your female reproductive organs removed. In this case, if you wish, it is possible for just the ovaries to be left in place.
About the colpectomy
A colpectomy is a surgical procedure in which the tissue of your vagina is removed. You may choose to have this procedure if you experience dysphoria due to the presence of the vagina or because you are suffering from other symptoms. A colpectomy cannot be performed if you wish to retain your womb. Are you considering a metoidioplasty or phalloplasty with urethral lengthening? In that case, a colpectomy is mandatory to reduce the risk of complications affecting the urethra. A colpectomy is a complex procedure with a high risk of complications (approximately 30%, or 3 in 10 people).
A colpectomy is therefore generally regarded as a major operation. You should expect a long recovery period, which can last from 6 weeks to sometimes as long as 6 months. You can find more information about preparing for a colpectomy here. Further details about the colpectomy procedure can be found in the animated video from Amsterdam UMC..
The operation
The colpectomy is performed using robot-assisted keyhole surgery. The operation can be carried out in conjunction with a hysterectomy or after a hysterectomy.
The details of the operation may vary between healthcare facilities in the Netherlands. It is therefore important to check the exact procedure with the healthcare facility you are having the surgery with. There are only a few places in the Netherlands that perform colpectomies. This may mean that you might have to travel further to have a colpectomy and you may be on the waiting list for longer.
Colpectomy combined with a hysterectomy
If you still have a womb (and possibly ovaries), a colpectomy is always combined with a hysterectomy. This is because the womb cannot remain in place once the vagina has been removed. It is possible to remove the vagina and womb (possibly including the ovaries) using a surgical robot.
First, the womb is detached and, if required, the ovaries and/or fallopian tubes are also detached. Once detached, they are removed via the vagina. The bladder, ureters and bowel are carefully avoided during this procedure. Damage to these organs is one of the risks of this operation (see complications and risks).
It is not possible to combine the removal of the vagina and womb in a single operation with the removal of the breasts (mastectomy); the operation would then take too long.
Robot-assisted keyhole surgery
The removal of the vagina is not carried out using conventional keyhole surgery, but with the aid of the Da Vinci robot. The main advantages of this technique are its high precision, the small incisions and less blood loss.
Further information about the operation
A small tube (the catheter) is inserted into the bladder via the urethra. The catheter is usually removed the following day. Once the vagina has been removed, there will be an internal wound where the vagina used to be. Externally, there are not really any visible signs of the operation.
The tissue between the urethra and the anus (the perineum) is closed with strong sutures. The skin is then closed as well. A small opening (about the width of one finger joint) remains just below the urethra, so that you can continue to urinate normally. Blood and wound fluid will also drain through this opening in the weeks following the operation. After the operation, fluid may still be produced from the glandular ducts around the urethra if you are aroused. If you undergo a urethral lengthening operation in the future, this opening will be closed.
Aftercare
Following a colpectomy, you will remain in the hospital for up to 2 days. The catheter will be removed the day after the operation, after which you should be able to pass urine within 6 hours. After passing urine, your bladder will be scanned to check that it is completely empty. If your bladder is not empty, the catheter will be reinserted. This happens in 1 in 5 people. The catheter will be removed again after about a week.
It is advised to wait until the wounds have completely healed before you go swimming, have a bath or visit the sauna. This is to prevent the stitches from dissolving too early and to avoid infections in the wound. This usually takes 6 weeks. You may, however, take a short shower. You must also avoid exercise or heavy lifting for six weeks, as this can lead to bleeding or excessive fluid production.
Bear in mind that the healing of the skin between the anus and the urethra can cause discomfort when walking or sitting (saddle pain) for up to 6 weeks.
Complications and risks during and after the operation
Unintended problems (complications) can arise with any operation, even if it has been carried out correctly. With vaginal removal, the risk of complications is around 30% (3 in 10 people). Most of these complications are mild, but some can be serious. After a colpectomy, you may experience complications related to the operation for up to 6 months.
- Post-operative bleeding during or after the operation: It is normal to lose blood and fluid during the procedure, but if there is a significant loss of blood, this is considered a complication. In such cases, a blood transfusion may be necessary. Bleeding can also occur after the operation (for example, at home). A further operation may be required to stop the bleeding.
- Infection: The incisions on the abdomen or in the vagina may become infected. An infection can occur when you have returned home or whilst you are still in hospital. Sometimes this can be treated with antibiotics, but in some cases, surgery is needed to resolve the infection.
- Fistula: In rare cases, an unintended passage may form between your bladder or bowel and the vaginal cavity; this is known as a fistula. Sometimes, further surgery is needed to remove the fistula.
- Thrombosis: With any operation, there is a slightly increased risk of thrombosis (a blood clot in a blood vessel). You can reduce this risk by getting up and moving around (as soon as possible) after the operation. You will also be given medication in hospital to prevent this.
- Damage to the bladder, bowel or urinary tract: During the operation, the bladder, bowel and urinary tract may be damaged. If this is noticed during the operation, it will be repaired immediately if possible. Sometimes a separate operation is required. If your bladder is damaged, you will be sent home with a urinary catheter, which must remain in place for at least seven days. Damage to the bowel is very rare but can have long-term consequences.
- Difficulty emptying the bladder (retentive bladder): It is possible that the bladder may not be able to empty properly after the operation. In that case, the urinary catheter will be reinserted, sometimes for a longer period. The bladder generally recovers fully.
- Bladder infection: The urinary catheter used during the procedure can sometimes cause a bladder infection. If you suspect you have developed a bladder infection, please contact your treating doctor or GP.
Sexual activity
It is recommended that you avoid any form of sexual intercourse for the first six weeks after the operation. You can, however, become sexually aroused or masturbate. Following a colpectomy, you will no longer be able to have vaginal penetration. After a hysterectomy (and removal of the vagina), your sexual experience may change.
For more information on sexuality after a colpectomy, please visit this page.
This text was edited on 3-11-2026
Next Step
We recommend that you go through all the information chapters step by step to get a complete picture of the various treatment options and the process involved!We strive to keep this information up to date. Do you have any additions or comments regarding the information above? Please email us at [email protected]
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Metoidioplasty
Metoidioplasty A metoidioplasty is an operation in which a penis of below-average size (a metoidio) is created using your existing genital tissue.
