Pelvic Exenteration in Mumbai
What is Pelvic Exenteration?
Pelvis has multiple compartments.
The anterior or front compartment has the urinary bladder with prostate gland in men and just the urinary bladder in women. There is a middle compartment in women which has the uterus, cervix. The back or posterior compartment has rectum and anus.
Behind the rectum there is the sacral or the tail bone.
Sometimes for advanced cancers – we have to remove more than one compartment. This refers to as pelvic exenteration.
Who needs Pelvic exenteration?
Advanced or recurrent cancers in pelvis
In my practice – advanced rectal cancers – which have spread out of rectum – some patients need this surgery.
Rectal cancer – usually presents with bleeding in stools amongst other symptoms – as detailed in one of my other videos.
Sometimes – we see patients with rectal cancer – cancer gone in bladder, prostate, uterus, vagina, or the sacral bone. In such patients exenteration is required to remove all affected organs.
Any Treatment given before Pelvic Exenteration?
What happens to urine and stool passage after surgery.
In a male patient where rectal cancer has involved prostate or lower part of bladder – we need to remove both the rectum and the bladder
Patient needs 2 stomas – rt side for urine and left side for stools.
In female patient – Uterus, cervix, vagina may be removed with rectum – needs colostomy for stool passage on left side – urine passage is protected.
In cases where the rectal cancer goes into bone – part of bone needs to be removed with rectum often needing plastic surgical reconstruction .
Sounds very mutilating? Why to do and is it worth doing?
Where and who should do this?
