Pelvic exenteration is a major surgical procedure that removes most or all pelvic organs and is reserved for severe, recurring cancers. The procedure is performed in about three hours under general anesthesia, and recovery involves monitoring, dressing, and cleaning surgical scars and stomas. Patients can go home about two weeks after surgery, but the procedure can significantly change a person’s life.
A pelvic exenteration is a major surgical procedure that involves the removal of most or all of the organs present in the pelvic region. It is typically reserved for severe, recurring cancers that don’t respond to minor surgery, radiation, or chemotherapy. The small and large intestines are realigned to bypass the pelvis and expel waste through surgical openings in the abdomen. Pelvic exenteration is most commonly performed on women with cervical cancer, although a male patient with severe prostate or rectal cancer may be a candidate.
Doctors exhaust all other cancer therapy options before considering pelvic exenteration. Cervical tumors and other malignancies in the region that persist despite aggressive treatment are usually fatal, and organ removal may be the last hope for sufferers. There are three general types of pelvic exenteration: anterior, posterior, and total. The bladder, urethra, and female reproductive organs are removed in an anterior procedure, and the rectum and reproductive organs are cut out in posterior surgery. Total exenteration involves the removal of all organs, tendons, muscles and fat tissue in the pelvic region.
The procedure is usually performed in about three hours while the patient is kept under general anesthesia. A surgeon makes a long incision along the lower abdomen and proceeds to carefully remove the appropriate structures. If the bladder is removed, a hole called a stoma is made in the abdomen and connected to the kidneys so that urine can be passed directly out of the body. Another stoma to empty the large intestine is created if the rectum is removed. Bags are attached to each ostomy to collect waste.
Soon after pelvic exenteration, a patient is admitted to a hospital room so that doctors and nurses can monitor their recovery. A stomach tube is usually inserted to keep food and liquids from entering the intestines for a few days. Nurses dress and clean surgical scars and stomas. A patient is typically instructed to stay in bed for about three days, then gradually begin walking to rebuild strength. Most patients can go home about two weeks after surgery.
Pelvic exenteration can significantly change a person’s life. Women stop menstruating and become infertile, and many men lose the ability to have erections. Waste collection bags should always be worn under clothing and changed regularly. With practice, support, and a positive attitude, a person can learn to overcome physical limitations and adjust to lifestyle changes after surgery.
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