Patient experience after pelvic exenteration: chronic pain and quality of life

Pelvic exenteration is a major surgery involving resection of the pelvic viscera and surrounding structures. Performed on patients with locally advanced or recurrent pelvic cancer, it is associated with high morbidity, persistent pain and low quality of life (QoL). This study aimed to determine the long-term prevalence of chronic pain and to characterise the pain and QoL experience in pelvic exenteration patients.

A telephone survey was undertaken, utilising patient-reported outcome measures: the Chronic Pain Grade Scale (CPGS) to assess pain and the Short Form-12 (SF-12) to measure QoL. Historic and demographic data were retrieved from hospital records to capture potential pre-, peri- and post-operative determinants. Data was analysed using descriptive statistics, correlation and comparative tests.

This study comprised 48 individuals, up to 13 years post-pelvic exenteration. Pain prevalence was 75%, with most patients reporting no to low-intensity pain, without disability (54%). SF-12 scores varied; physical scores were significantly lower than population norms, while mental scores were preserved. Pain intensity and disability (CPGS sub-scores) were associated with lower QoL, a relationship that was consistent across pain grades.

These findings indicate that the post-pelvic exenteration experience is characterised by reduced physical QoL and notable pain, highlighting the importance of early pain management optimisation. This research provides surgical candidates with authentic patient insight into life after surgery in a complex yet understudied population. Prospective longitudinal research is recommended to further examine patient trajectories and predictors of pain and poor QoL, enabling better targeted pain management.