Pelvic exenteration

Pelvic exenteration (or pelvic evisceration) is radical surgical treatment that removes the urinary bladder, urethra, vagina, cervix, uterus, fallopian tubes, ovaries, rectum, anus, and in some cases, the vulva.

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The procedure leaves the patient with a permanent colostomy, where the colonic contents drain into a bag that attaches on the left side of the abdomen. The bladder is reconstructed from bowel to provide a reservoir which empties into a pouch on the abdomen.

Indications

Pelvic exenteration is most commonly used in cases of advanced or recurrent cervical cancer, vaginal cancer, and vulvar cancer when more conservative surgical options are not technically possible or would not be able to remove the extent of the tumor.

History

The procedure was first described by Alexander Brunschwig in 1948.^[1][2]

References