Social and psychological adjustment following pelvic exenteration

Abstract

In order to evaluate their adjustment to pelvic exenteration, 15 women were studied over a 3 year period. Despite the stresses to which these patients were subjected, over-all social and psychological adjustment was favorable. The majority returned to their preoperative positions and enjoyed regular recreational activities. Only 2 patients were significantly disturbed, according to psychometric examinations. One of these had been institutionalized for mental illness several years before the cancer diagnosis. The second patient, the only one in the study to die from malignancy, died of metastasis six years postoperatively. Two findings not previously reported involved phantomization of the vagina and erotization of the colostomy stoma in cancer patients. Autoerotic practices and dreams with sexual content were reported after operation. Since death is a certain outcome of advanced cervical malignancy without exenterations, and satisfactory social and psychological adjustment was found in our postexenteration group, this form of cancer therapy appears more hopeful than patients and surgeons now view it. Supportive psychotherapy, occurring coincidentally to this investigation, may have further improved the lives of the postexenteration patients.