What is pelvic exenteration in women?

Pelvic exenteration is a type of operation used to treat cancer. It’s usually used for women with cervical cancer that has come back after treatment. It’s also used to treat rectal, womb, vaginal and vulval cancers.

During the operation, the bladder, part of the bowel, ovaries, womb, cervix and vagina are removed. Although this is a major operation, it can cure the cancer for some people. The operation is only suitable if there are no signs of cancer anywhere else in the body.

There are different types of pelvic exenteration:

  • Anterior exenteration – This is when the bladder and internal reproductive organs are removed.
  • Posterior exenteration – This is when the lower part of the large bowel (rectum) and internal reproductive organs are removed.
  • Total exenteration – This is when the bladder, rectum and internal reproductive organs are removed.

The type of operation you have will depend on your type of cancer and your individual situation. Your nurse and surgeon will be able to support you when deciding if the operation is right for you.

The pelvic exenteration operation

Pelvic exenteration is a type of operation that involves removing the bladder or part of the lower bowel (rectum), or both, and the internal reproductive organs (the ovaries, womb, cervix and vagina). This operation is only done if there are no signs of cancer anywhere else in the body.

Only specialist surgeons, who are trained and experienced in doing this type of surgery, should carry out pelvic exenteration. You may be referred to a specialist centre for the operation.

It is important to discuss the benefits and risks with your surgeon, before making a decision about the operation. This is a major operation, but can cure the cancer in some people.

Before the operation, you will be referred to a specialist cancer nurse. They will give you information and emotional support. In some units, the specialist nurse may be called your key worker.


When pelvic exenteration is done in women

This operation is most often used to treat women who have cervical cancer that has come back in the pelvis after treatment.

It may also be used to treat the following cancers that have come back in the pelvis after treatment:

Rarely, pelvic exenteration may be used to treat other cancers in the pelvis.


Types of pelvic exenteration operation in women

There are different types of pelvic exenteration. The operation you have depends on:

  • the type of cancer you have
  • where the cancer is in your pelvis
  • what treatments you’ve had before.
One of the following operations may be done:

Anterior exenteration (removing organs in the front part of the pelvis)

In this operation, the bladder and internal reproductive organs are removed. After the bladder is removed, you’ll need a new place for urine to leave your body. The surgeon will make a new opening (a stoma) on your tummy (abdomen) wall for this. This is known as a urostomy.

Illustration showing the female pelvic organs. The areas removed during anterior pelvic exenteration are shaded over.
Illustration showing the female pelvic organs. The areas removed during anterior pelvic exenteration are shaded over.

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Posterior exenteration (removing organs in the back part of the pelvis)

In this operation, the lower part of the large bowel (rectum) and internal reproductive organs are removed. The surgeon will make a new opening (a stoma) on the tummy wall for bowel motions (poo) to leave the body. This is called a colostomy. You’ll wear a bag over the stoma to collect your bowel motions.

Illustration showing the female pelvic organs. The areas removed during posterior pelvic exenteration are shaded over.
Illustration showing the female pelvic organs. The areas removed during posterior pelvic exenteration are shaded over.

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Total exenteration (removing all the organs in the pelvis)

In this operation, the bladder, rectum and internal reproductive organs are removed. After the operation, you’ll have two new openings (stomas) on your tummy wall. One of these will be a new place for urine to leave your body (urostomy). The other will be a new place for bowel motions to leave your body (colostomy).

Illustration showing the female pelvic organs. The areas removed during total pelvic exenteration are shaded over.
Illustration showing the female pelvic organs. The areas removed during total pelvic exenteration are shaded over.

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Having pelvic exenteration

Pelvic exenteration takes about eight hours. After the operation, you will have new ways for urine and bowel motions to leave your body.