Types of pelvic exenteration

Your surgeon may not know what type of pelvic exenteration you need until they start the surgery. The type you have will depend on:

  • the type of cancer you have
  • where the cancer is in the pelvis
  • what treatments you have had before.

The two main types are posterior exenteration and total exenteration.

There is a third type of surgery, sometimes called anterior exenteration. In men this is more commonly called a radical cystectomy. This is for invasive and advanced bladder cancer. The bladder and prostate are removed.

Posterior exenteration

This operation involves removing organs in the back part of the pelvis. The surgeon will remove:

  • the lower part of the bowel (the rectum and sometimes the anus)
  • the prostate.

The male pelvic organs, showing the areas removed during posterior exenteration:

The male pelvic organs, showing the areas removed during posterior exenteration.

Total exenteration

This surgery involves removing all the organs in the pelvis. The surgeon will remove:

  • the bladder
  • the lower part of the bowel (the rectum and sometimes the anus)
  • the prostate.

Usually urine (pee) drains from the kidneys, through tubes called ureters, to the bladder. Urine is stored in the bladder until you are ready to pass urine. After the bladder is removed, urine needs to leave the body in a different way. You will have a urinary diversion.

We have more information about urinary diversion in our bladder cancer content.

The surgeon makes an opening on the tummy (abdomen) called a stoma. When the bladder is removed, the surgeon connects the end of the ureters to this opening. Depending on the type of urinary diversion you have, you may wear a bag over the stoma to collect urine.

The male pelvic organs, showing the areas removed during total exenteration:

The male pelvic organs, showing the areas removed during total exenteration.

Having a colostomy after male pelvic exenteration

For both posterior and total exenteration you will have a colostomy.

Usually stools (poo) leave the body through the rectum and the anus. After the rectum is removed, stools need to leave the body in a different way. The surgeon makes an opening on the tummy (abdomen) called a stoma. They connect the end of the bowel to this opening. This is called a colostomy. You wear a colostomy bag over the stoma to collect the stools.

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