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what is vaginal cuff

What Is A Vaginal Cuff? The Surprising Truth.

TLDR: We look at what is a vaginal cuff after hysterectomy surgery. The risks, how to avoid them and answer common questions. This honest and open article based on Rachel’s teal; life experience may surprise you. 

what is a vaginal cuff
Rachel’s Experience – what is a vaginal cuff

I first heard of the vaginal cuff a few months after my hysterectomy surgery. So prior to my surgery I would not have even known to ask what a vaginal cuff is

Personally, I feel let down by my doctors for not explaining it to me. I know there is a lot of new lingo to learn when you get wrapped up in the female reproductive health issues lifestyle but to me ‘cuff’ is a pretty easy one to learn. 

Especially when I am regularly trying to type and understand ‘bilateral oophorectomy’ (both ovaries removed, for educational purposes!) 

However, I think it would have gone over my head anyway. I needed to have the surgery, cuff or no cuff. So it didn’t really matter to me then what a vaginal cuff was. I was just getting on with it, and going through the motions. 

It wasn’t until a few months after my hysterectomy surgery that when I started thinking about sex after a hysterectomy that I thought ‘what the hell happens to the penis in there!’ Especially as I had my cervix taken too. 

So, I wanted to explain to you what is a vaginal cuff. If you are pre or post hysterectomy surgery then I hope this helps you. 

I try to keep things lighthearted, honest and open. I won’t share horror stories (I don’t have any to share) just honest accounts of my real life hysterectomy experience. 

What Is A Vaginal Cuff?

Put simply it is where they sew you up, at the top of the vagina, where the cervix would have been. The surgeon needs to close the vagina somehow, so that is where the vaginal cuff comes in. 

The surgeon only needs to make you a vaginal cuff if you have a total or radical hysterectomy. This means everything has been taken (ovaries, cervix, fallopian tubes and nearby tissue) 

This is what I had and you can read about my experience recovering from my surgery here as well as see pictures of my scars after my hysterectomy

what is a vaginal cuff
1 week post total hysterectomy (therefore vaginal cuff)

How Long Does A Vaginal Cuff Take To Heal?

My doctor explained the recovery process of my hysterectomy well to me, but didn’t mention that this is largely because of the vaginal cuff. Essentially your insides have been sewn up and they need to heal. 

You need to be signed off by your doctor for any of the following:

  • Heavy lifting  
  • Sex 
  • Bathing / swimming 
  • Inserting anything into your vagina 
  • Avoid straining for bowel movements (fibre, we’re looking at you) 

You will be looking at anything from 6 – 12 weeks for a vaginal cuff to heal. I got signed off at 10 weeks for the above activity. I still waited until 12. I cannot tell you how wonderful that… bath was : )

Side note: I highly recommend telling your partner the doctor says you must avoid heavy lifting for another 2-4 weeks. Get them carrying the washing basket for a little longer and enjoy the time off. It’s only a white life after all!

Your doctor may suggest pain medication and/or medication to stop infection. I didn’t take many painkillers after my hysterectomy. I wasn’t trying to be a hero, I genuinely didn’t need them. However the doctor did tell me to take them, even if I didn’t feel like I needed them. 

You should get a few checks with your doctor to see how your vaginal cuff is healing. 

Can A Vaginal Cuff Tear? 

There are risks that it could tear, which is why it is very important to stick to the rules outlined above and follow your doctors advice. And don’t carry the washing basket! 

You will be at slightly higher rise of the vaginal cuff tearing if you:

  • Are overweight 
  • Smoke
  • Have unmanaged diabetes 
  • Have sex before it is healed 
  • Have chronic constipation (you dont want to be pushing!) 
  • Have weak pelvic floor muscles
  • Have severe coughing 
  • Have a weak immune system

How Will You Know If  You Have A Tear In The Vaginal Cuff? 

You might notice: 

  • Sudden and severe abdominal pain
  • Vaginal discharge that is unusual
  • Bleeding from the vagina 
  • Pressure in your pelvis 
  • Unusual and bad smell coming from your vagina

Remember when I promised no horror stories? Well, don’t worry. I know this sounds scary but vaginal cuff tears occur in less that 1% (0.24-0.31% to be precise) of hysterectomy patients according to this study

They describe it as a ‘rare and distinct complication’. So I repeat, don’t panic. 

Do You Have A Vaginal Cuff If You Keep Your Cervix? 

Nope, if you are keeping your cervix there is no need for a vaginal cuff. I had my cervix removed as I had tumours on it and the doctors felt it might be better to get rid of it all (I had borderline ovarian cancer) incase it came back. 

If you don’t want a vaginal cuff you should chat to your doctor about the options of keeping your cervix. I could have pushed to keep mine. 

Remember that second opinions are always available and it is your body. 

what is vaginal cuff

Does Sex Feel Different With A Vaginal Cuff ?

Sex is different for everyone, hysterectomy or not, vaginal cuff or not. So it is hard to say. I have written in depth about sex after a hysterectomy which I recommend you read.

The main thing you may worry about will probably be similar to what I worried about… will the vaginal cuff break during sex? How ‘hard’ can sex be with a vaginal cuff? 

I asked my doctor. 

Because I have no shame : ) 

(plus I was only 30 and still wanted to enjoy a sex life, thank you very much.)

Their response was that the cuff is scar tissue which is incredibly thick. If you think about a scar healing on your body (if you have witnessed this) then you can understand how thick scar tissue is. 

Personally, this resonated with me as I have had a laparotomy before and experienced recovering from a laparotomy and saw first hand the scar healing. 

I mean, my entire stomach was cut open and sewn back together. When I push that scar and the scar tissue it is very firm. I am very confident not much would get through that. 

So it is kind of the same for a vaginal cuff. I think even if you have hard or rough sex, a penis or sex toy will not break through that scar tissue. 

What Is A Vaginal Cuff Conclusion

A vaginal cuff is where the surgeon sews up the vagina after total radical hysterectomy surgery, when the cervix is removed. Complications are rare but it is important to follow your care plan and attend your check ups. Oh, and not do too much heavy lifting AKA clothes washing. 

Now, thoughts on a petition to change the name from ‘vaginal cuff’ I am so done with writing that/calling it that  : )

Any more questions on what is a vaginal cuff my email is [email protected]

Always happy to chat. 

Rachel xx

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