What is pelvic exenteration?

Pelvic exenteration is an operation (surgery) to remove multiple organs in the pelvis. The lower bowel (rectum) and the prostate are removed. Depending on the type of operation, the bladder may also be removed. The operation is sometimes called pelvic clearance.

We have more information about types of pelvic exenteration.

This operation can be done to treat cancers in the pelvis, including:

It can be used when cancer has spread within the pelvis, or has come back in the pelvis after other treatments.

You may have pelvic exenteration if there is also cancer in other parts of the body, such as the lungs or liver. This is only if these areas can be treated after the pelvic exenteration.

Pelvic exenteration can cure cancer in some people. But it is a major operation. It is important to discuss the benefits and risks with your surgeon, before deciding (consenting) to have it.

Before having pelvic exenteration

Pelvic exenteration is a major operation. It is only suitable for a small number of people. Together, you and your healthcare team will decide whether the operation is right for you. As part of this process you will:

  • have tests to check you can cope with the operation
  • talk to your healthcare team about any concerns you have.

If you consent to have the operation, you will go to a specialist centre to meet with a team of specialists involved in your care.

We have more information about what happens before this operation.

Having pelvic exenteration

Pelvic exenteration usually takes about 8 hours, but it can take longer. Two or more surgeons will work together. These could include:

  • a urologist – a surgeon who specialises in the urinary system
  • a colorectal surgeon – a surgeon who specialises in bowel cancers
  • a plastic surgeon – a surgeon who specialises in reconstruction.

After pelvic exenteration, you will have a colostomy. You may also have a urinary diversion. Talk to your specialist nurse about any concerns you have.

After you have pelvic exenteration

After your operation, you will usually stay in hospital for 2 to 3 weeks. The first few days may be in an intensive care or high-dependency unit.

When you wake up after the operation, you will have dressings on your wounds from the surgery. You may also have drips and drains.

Getting moving

Your nurse or physiotherapist will encourage you to start moving around after the operation. A physiotherapist will show you gentle exercises and give you advice.

Stoma care

After a few days, you will be able to start to care for your own stoma and change the bag. Your stoma nurse will give you information and support to help you adjust.

Going home

When you go home, you will need extra help and support for a few weeks. Before your surgery, tell the hospital staff or your specialist nurse if you are worried about managing at home. They can arrange help for you.

When you go home you will have injections to thin the blood and reduce the risk of blood clots.

You may find it takes several months after surgery to recover. As time goes on, you will start to feel stronger and have more energy.

We have more information about what happens after pelvic exenteration.

Your sex life after pelvic exenteration

The physical changes to your body after the operation (surgery) can mean changes to your sex life. How the operation affects you physically and emotionally will vary. You may need to make some adjustments. Your surgeon and specialist nurse will talk to you about the changes you may have. It can help to talk about any questions or worries you have.

We have more information about:

You may not feel like having sex for a while. If you have a partner, you may both need time to get used to any changes. There are different ways you can show your partner you care about them. This can include spending time together and showing affection through touching, holding hands or putting an arm around their shoulder. You may also find new ways to share sexual pleasure.

After treatment, you may find that your sex life slowly improves. If you continue to have difficulties, ask your specialist nurse or doctor for advice. They can refer you for more specialised support if needed.

Fertility after pelvic exenteration

Pelvic exenteration can affect your ability to have children (your fertility). The operation can make getting and keeping an erection difficult. It can also affect your ability to ejaculate.

You can ask to be referred to a fertility clinic before having cancer treatment. You may be able to store sperm which can be used later in fertility treatment.

We have more information about fertility in men.

Your feelings about pelvic exenteration

You may have many different emotions about pelvic exenteration. This can include stress, anger, anxiety and fear.

You may also find it difficult to cope with needing help from others while you are recovering. These are all normal feelings. They are part of adjusting. Talking about how you feel can help.

Sometimes it is easier to talk to someone who does not know you. You could ask your cancer doctor or GP to refer you to a counsellor.

Where to get help and support

There are organisations that can offer you practical and emotional support.

  • IA – Ileostomy and Internal Pouch Association

    IA – Ileostomy and Internal Pouch Association offers support to help anyone who has had, or is about to have, their colon removed and has an ileostomy or internal pouch.

  • Urostomy Association

    Urostomy Association offers support and advice to anyone who has had, or is about to have, surgery resulting in a urostomy. Also offers support for families and carers.

  • Bowel Cancer UK

    Bowel Cancer UK offers information and support to people affected by bowel cancer.

  • The HPV and Anal Cancer Foundation

    The HPV and Anal Cancer Foundation provides support and information for people having treatment for anal cancer, and their carers and families.

  • LGBT Foundation

    LGBT Foundation provides advice, support and information to people who are gay, lesbian, bisexual or transgender, and their families and friends.

  • Stonewall

    Stonewall provides information and support to the LGBT community.

  • College of Sexual and Relationship Therapists

    College of Sexual and Relationship Therapists has a directory of sex and relationship therapists.

  • Human Fertilisation and Embryology Authority

    Human Fertilisation and Embryology Authority provides free impartial information to people affected by fertility treatment. Has information about choosing a clinic.

  • Fertility Friends

    Fertility Friends is an online community for people coping with infertility or adoption.

  • Fertility Network UK

    Fertility Network UK provides support for anyone with fertility problems.