Pelvic exenteration: effects of surgery on quality of life and body image--a prospective longitudinal study

The goal of this study was to evaluate the impact of reconstructive and nonreconstructive surgical procedures on quality of life and body image for women who undergo pelvic exenteration.

Twenty-eight patients were assessed in a prospective study with a preoperative semistructured interview and an objective assessment (T1). Interviews and questionnaires were repeated 4 (T2) and 12 (T3) months postoperatively. The women were divided into groups with two, one, or no ostomies. A separate comparison was made of women with and without vaginal capacity. Quality of life was defined in terms of five categories according to the definition of health proposed by the World Health Organization: physical and psychosocial health; marital and sexual status; medical interactions.

At all points in time, the patients' quality of life was affected most significantly by worries about the progression of the tumor. Twelve months postoperatively, patients with two ostomies reported a significantly lower quality of life (P = 0.008) and poorer body image (P = 0.002) than patients with no ostomy. At T3, patients with vaginal capacity reported fewer problems in all categories related to quality of life and significantly (P = 0.015) fewer sexual problems.

An evaluation of quality of life and body image demonstrates the benefits of newer techniques for organ reconstruction. Thus, organ reconstruction should be performed whenever possible in patients with pelvic exenteration.