There are two types of vaginal cancer: primary and secondary. Primary vaginal cancer is rare. The occurrence of clear cell carcinoma of the vagina in young girls is thought to be related to the use of estrogen by the patient’s mother during pregnancy. Vaginal epithelial cell carcinoma accounts for 75% of primary vaginal carcinomas, while sarcomas, melanomas and adenocarcinomas account for the rest. It occurs mostly in the upper 1/3 and posterior wall of the vagina, and it is important to note the possibility of multiple centers. If the tumor involves the vaginal part of the cervix and exceeds the ectocervix, it should be considered as cervical cancer. I. Abnormal manifestations Small amount of irregular bleeding, foul-smelling discharge and pain after menopause. Risk factors 1. Prolonged use of uterine and vaginal supports due to uterine prolapse and bulging of vaginal wall, which causes long-term chronic irritation of the vagina. 2.History of pelvic radiation therapy. 3.A variety of infections, including sexually transmitted diseases, HPV (human papillomavirus) infection, chronic inflammation. 4.Mother taking estrogen during pregnancy. This kind of situation is most common in young women with clear cell carcinoma of the vagina, and is regarded as a high-risk group for vaginal cancer. Early marriage, multiple pregnancies and multiple births. According to some data, 33% of vaginal cancer patients are married below 17 years old, and 58.4% of vaginal cancer patients have given birth more than 4 times. 6.Total hysterectomy history patients, the incidence of vaginal cancer accounts for 48%. 7.Vaginal cancer accounts for 16.7% in those who have suffered from cervical intraepithelial neoplasia or cervical invasive carcinoma. Staging: mainly squamous carcinoma, adenocarcinoma is less common. Related examination 1. Vaginal speculum can observe the whole vaginal wall. If necessary, iodine solution can be used for vaginal treatment to help differentiate the boundary of the tumor. 2.Rectovaginal triple diagnosis can be performed to find out whether there is submucosal or paravaginal invasion or rectal involvement. 3, A few can be diagnosed by Pap smear and pelvic examination. 4, Chest X-ray examination and intravenous pyelogram, cystoscopy and rectosigmoidoscopy can be used as routine examination. 5, CT and MRI can identify intraperitoneal and extraperitoneal lesions, and MRI can also identify radiotherapy fibrosis lesions and recurrent tumors. V. Treatment The treatment of vaginal cancer is relatively difficult, especially the principle of individual treatment should be emphasized. According to the anatomical characteristics of vagina, the surgery should be vagina plus extensive hysterectomy and pelvic lymph node dissection. Elderly patients are difficult to tolerate such operation, and young women are not easy to accept such operation, so the treatment of this disease is mainly radiotherapy. In conclusion, the treatment of vaginal cancer should be handled according to patients’ age, systemic condition, especially tumor size, site of occurrence and clinical staging. 1.In situ cancer can be treated with surgery, radiotherapy and 5-Fu cream therapy, C02 laser therapy and so on. 2.Invasive cancer can be treated with surgery or radiotherapy according to different clinical stages. Surgery has certain value for patients with stage I~IV, but radiotherapy is still the main treatment method. Except for the application of intracavitary treatment for early primary vaginal cancer, most of the patients use intracavitary radiotherapy together with extracorporeal radiotherapy. 4. The treatment of secondary vaginal cancer is a part of the overall treatment of primary vaginal cancer, and radiotherapy is feasible for isolated vaginal metastases, and its principle can be referred to the radiotherapy of primary vaginal cancer. The principle can refer to primary vaginal cancer radiotherapy. If vaginal metastasis of rectal cancer is treated with preoperative radiotherapy, the vagina can be partially resected at the time of surgery as appropriate. Vaginal metastasis of chorionic epithelial cancer can be treated mainly with chemotherapy and supplemented with radiotherapy. (1) The appropriate time for surgical diagnosis and treatment of vaginal fistula is 5-6 months after the fistula occurs, or more than 3 months after the operation, and 5-7 days after menstruation. (2) The fistula is small and surrounded by granulation tissue proliferation, and urine leakage may occur when the bladder is full. Instruct the patient to avoid holding urine, empty the bladder in time, and use 1:5000 potassium permanganate solution to sit in the bath every night, and then use 1:1000 benzalkonium bromide to irrigate the vagina, to create a good environment for postoperative incision healing. Postoperative care (1) dietary guidance: after anal exsufflation, patients should be instructed to enter a light and easy-to-digest liquid diet, and then gradually transition to general food, to keep the bowel movement smooth, to avoid increasing abdominal pressure and affecting the incision healing. (2) Patients should lie down as much as possible for 1~9 days after operation to keep the wound surface dry and clean, which is conducive to incision healing. (3) after vesicovaginal fistula repair surgery to retain the urinary catheter needs 7 to 9 days, fistula larger need to be retained for 12 to 14 days, pay attention to the application of saline intermittent flushing bladder, to keep the drainage tube clear, to prevent blockage of the drainage tube and lead to overfilling of the bladder so that the repair of the fistula cracked. (4) Strengthen the bladder function training, because of the postoperative patients long-term leakage of urine, bladder capacity is obviously reduced, should encourage patients to early bed activities, urinary catheter regular clamping and opening (general clamping tube 30 minutes to release urine once), so that the bladder capacity gradually increased. After extubation, patients should be instructed to urinate regularly so as not to overfill the bladder and affect incision healing. 3.Discharge guidance after discharge to maintain a regular life, emotional stability, avoid early heavy labor; prevent colds; avoid laughing, coughing and other activities that increase abdominal pressure; pay attention to the intake of green vegetables, fruits, drink more water, appropriate exercise, keep bowel movement; prohibit sexual life within 3 months after surgery; avoid vaginal delivery within 1-2 years, so as to avoid impotence recurrence; the emergence of abnormalities in a timely manner to the doctor.