Having a pelvic exenteration

Pelvic exenteration is a long operation. It usually lasts about eight hours and there will be at least two surgeons. They will try to remove the cancer and reconstruct or replace some of your organs.

After the pelvic exenteration operation, you may have a urostomy and colostomy:

  • Urostomy – This is a new way for urine to leave your body after the bladder is taken out. The surgeon will make a new opening in your tummy (abdomen), called a stoma. There are different types of urostomy where an internal or external pouch will collect the urine. You will have the type most suitable for you.
  • Colostomy – This is a new way for bowel motions (poo) to leave your body after the bowel and anus are removed. You will have a stoma in your tummy for this. An external bag will collect your bowel motions.

Your specialist nurse will be able to support you and answer any questions you may have.

What happens during the pelvic exenteration operation?

Pelvic exenteration is a long operation that takes about eight hours. It’s usually carried out by two or more surgeons, who work together to remove the cancer and reconstruct or replace some of the organs.

The surgeons involved in the operation include a specialist cancer surgeon (oncological surgeon) and a plastic surgeon (reconstructive surgeon).

After a pelvic exenteration, you will have a urostomy and colostomy made.


Urostomy

After the bladder is removed, you will need a new place for urine to leave your body. The surgeon will make a new opening (stoma) on your tummy wall for this, called a urostomy.

There are different types of urostomy. Your surgeon will explain which one is most suitable for you.

Ileal conduit

This is the most common type of urostomy. After the operation, you will wear an external bag to collect your urine.

The surgeon removes a section of the small bowel and joins the tubes coming from each of the kidneys (ureters) to one end of it. They then bring the other open end of the bowel out through a small opening (stoma) in the skin of the tummy wall. Urine made by the kidneys will pass out of the body through this stoma.

An ileal conduit
An ileal conduit

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You will wear a flat, watertight bag over the stoma to collect your urine. The bag will fill with urine, and you will need to empty it regularly. Your specialist stoma nurse will show you how to take care of the stoma and the bag.

Continent urinary diversion (internal pouch)

With this type of operation, you don’t need an external bag to collect your urine. Your surgeon uses a piece of the small bowel to make a pouch that can store urine inside the tummy (abdomen). The pouch is connected to an opening (stoma) on the tummy wall. You empty urine from the pouch by putting a tube (catheter) into the stoma. This is called self-catheterisation.

A continent urinary diversion (internal pouch)
A continent urinary diversion (internal pouch)

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Colostomy

After the lower part of the bowel (rectum) and anus is removed, the remaining end of the bowel will be brought up to an opening (stoma) on the tummy wall. This is called a colostomy. You'll wear a bag over the stoma to collect bowel motions. Your specialist stoma nurse will show you how to change the bag and take care of the stoma.

If the anus isn’t removed in the operation, it may be possible to join the bowel together to avoid a permanent stoma. If a temporary stoma is needed, it can be reversed in the future. You can discuss this with your surgeon to see if it is an option.

We have more information on living with a stoma, which you may find helpful.

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