removal of the urinary bladder, distal ureter, vagina, uterus, adnexa, and adjacent lymph nodes; a urinary diversion or bladder substitution is necessary.
anterior pelvic exenteration
Heroic surgery in the anterior pelvic cavity, consisting of excision of the male (cystoprostatectomy) or female pelvic content, bladder and urethra, while sparing the rectum. Urinary output is often addressed by anastomising the ureters into an ileal pouch made from small intestine, which is then connected to the abdominal wall. Vaginal reconstruction may be performed during the exenteration or later.
Davis et al described a patient with disease metastatic to regional lymph nodes who was without evidence of disease 10 months after neoadjuvant platinum-5-FU and radiotherapy, anterior pelvic exenteration, and adjuvant paclitaxel and carboplatin (10).