Pelvic Exenteration

Types of pelvic exenteration

There are different types of pelvic exenteration. Your health care team will decide the type of exenteration you need. This can depend on where the cancer is and what other treatments you’ve had.

If you have had genital gender-affirming surgery you may have questions about how this affects your treatment. Your health care team can give you information about what your operation will involve or you can contact our Ask the Nurse service. You can also find support through charities like OUTpatients, which support LGBTIQ+ people affected by cancer.

Total exenteration

This operation removes all the organs in the pelvis.

For women, trans men, and other people assigned female at birth this may include:

• the bladder
• the cervix
• part or all of the vagina
• the womb (uterus)
• the ovaries
• the lower part of the large bowel (rectum and anus)
  
  

For men, trans women, and other people assigned male at birth this may include:

• the bladder
• the lower part of the large bowel (rectum and anus)
• the prostate
• glands that produce semen (seminal vesicles)
  
  

Anterior exenteration

This operation removes organs in the front (anterior) part of the pelvis.

For women, trans men, and other people assigned female at birth this may include:

• the bladder
• the cervix
• part or all of the vagina
• the womb (uterus)
• the ovaries
  
  

For men, trans women, and other people assigned male at birth this may include:

• the bladder
• the prostate
• glands that produce semen (seminal vesicles)
  
  

Posterior exenteration

This operation removes organs in the back (posterior) part of the pelvis.

In women, trans men, and other people assigned female at birth this may include:

• the cervix
• part or all of the vagina
• the womb (uterus)
• the ovaries
• the lower part of the large bowel (rectum and anus)
  
  

In men, trans women, and other people assigned male at birth this may include:

• the lower part of the large bowel (rectum and anus)
  
  

Preparing for surgery

Your health care team will do scans and tests to make sure that pelvic exenteration is the best treatment option for you and that you’re fit for surgery. They'll also make sure that you understand what the operation will involve so you can make an informed decision. It may help to involve your partner, family, or close friends in the process so that you have support before, during and after the surgery. You could ask them to come to your appointments with you to take notes, ask questions, or just provide moral support. We have more information for family and friends of people with bowel cancer.

After surgery

Recovering from pelvic exenteration surgery can be difficult. Immediately after the operation you may be in an intensive care unit for a few days and it’s likely that you’ll spend a few weeks in hospital. You’ll be given physiotherapy to help with your recovery. Once you’re home you’ll need extra help as your body heals. You may find walking difficult for the first few days and may need to use a mobility aid until you can walk independently. If you live alone and don’t have anyone who can physically support you, you should tell your health care team so that they can organise support for you.

Your bladder or rectum may have been removed during the operation. If this happens you'll have a colostomy or urostomy, which are also called stomas. A colostomy is where a section of the large bowel is brought through an opening on your stomach area. A urostomy is where a section of your bladder is brough through an opening on your stomach area. Your poo or pee is collected in a bag attached to the skin around this opening. Read more about stomas.

You may have reconstructive surgery after a pelvic exenteration operation. This involves using plastic surgery to rebuild parts of the body that have been removed. This may be done at the same time as your pelvic exenteration surgery or at a separate time. You can talk to your health care team about your options.

Impact

Emotional wellbeing

Having a major operation like pelvic exenteration can be physically and emotionally difficult. How you feel is personal to you and there is no right or wrong way to feel. It’s important to take time to process how you feel. You may find it helpful to talk to someone you’re close to, or to talk to someone who doesn’t know you. Your health care team or GP can refer you to a counsellor if you think it would help you. You can also find support from other people who have been through a similar experience by using our forums, Facebook groups and peer support line. Find out more about how we can support you.

Sex life

Pelvic exenteration can cause physical changes to your body that impact your sex life. You can talk to your health care team about any changes or questions you may have or contact our Ask the Nurse service. You can read more about cancer and your sex life on the Macmillan website.

Fertility

Pelvic exenteration can affect your ability to have children (fertility). In women, trans men and other people assigned female at birth, it may remove parts of the body needed to get pregnant. In men, trans women and other people assigned male at birth it can remove the ability to produce sperm or get an erection. You can ask to be referred to a fertility clinic before your treatment to discuss your options. This could include storing eggs or sperm or looking into other ways of having children such as surrogacy or adoption. Read more about fertility.

Page updated: September 2024