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Radical Surgery

Pelvic Exenteration

Radical surgery for advanced or recurrent pelvic tumors. We offer a second chance at cure when other options have failed, with specialized multidisciplinary teams.

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What is pelvic exenteration?

Pelvic exenteration is a radical surgical intervention consisting of en bloc removal of pelvic organs affected by a tumor. It is the treatment of choice for locally advanced or recurrent pelvic tumors that cannot be treated with other techniques.

Although it is a highly complex surgery, it offers the possibility of cure in patients who would otherwise only have palliative options. Advances in surgical and reconstruction techniques have significantly improved outcomes and postoperative quality of life.

Types of pelvic exenteration

Different modalities exist depending on which organs must be removed:

Anterior exenteration

Removal of anterior pelvic organs: bladder, uterus (in women), prostate (in men), preserving the rectum.

Posterior exenteration

Removal of the rectum and posterior reproductive organs, preserving the bladder and urinary system.

Total exenteration

Removal of all pelvic organs: rectum, bladder, uterus/prostate, and adjacent reproductive structures.

Extended exenteration

Also includes bony structures (sacrum, pubis) or lateral pelvic walls when affected.

Indications for pelvic exenteration

This surgery is indicated in the following situations:

Central pelvic recurrence

Recurrence of colorectal, gynecological, or urological cancer in the central pelvis after previous treatment.

Locally advanced tumor

Primary tumors infiltrating multiple pelvic organs but without distant metastases.

Tumor fistulization

Tumors that have created abnormal communications (fistulas) between pelvic organs.

Radiotherapy failure

Tumor persistence or recurrence after previous radical pelvic radiotherapy.

Reconstruction techniques

Reconstruction is a fundamental part of pelvic exenteration:

Urinary diversion

Creation of an ileal conduit (Bricker) or neobladder to divert urine when the bladder is removed.

Colostomy

Exteriorization of the colon to the abdominal wall when the rectum is removed, temporary or permanent.

Musculocutaneous flaps

Use of vascularized tissues (rectus abdominis, gracilis) to fill the pelvic defect and improve healing.

Vaginal reconstruction

In women, vaginal reconstruction using flaps to maintain function and anatomy.

Our experience in pelvic exenterations

At Quenet-Torrent Institute we have one of the largest experiences in pelvic exenteration in Spain. Our multidisciplinary team includes oncological surgeons, urologists, gynecological oncologists, plastic surgeons, and stomatherapists.

We perform an exhaustive evaluation of each case to determine surgical viability and plan the optimal strategy. We use advanced technology, including robotic surgery when applicable, to optimize oncological and functional outcomes.

Pathologies that may require pelvic exenteration

Pelvic exenteration is applied in advanced or recurrent tumors from various locations.

Gynecological tumors

Locally advanced cervical, endometrial, or vaginal cancer.

More information

Pelvic sarcomas

Retroperitoneal sarcomas with pelvic involvement.

More information
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