The major problems of psychosexual adjustment to total pelvic exenteration (TPE) were identified during interviews with patients who have undergone this aggressive cancer treatment. The “normal” psychosexual adjustment encompasses psychologic, social, and sexual factors. Based on these known influencing factors of adjustment, patients were questioned concerning their personal experiences in semistructured interviews. Specific problems involved such issues as body image, social life-style, and sexual relations and practices. Nurses have the professional responsibility of nurturing the adjustment of these individuals such that they redevelop their life to what they consider a respectable and worthwhile level. By specific interactions with the patient and her partner during the preoperative and postoperative periods, the nurse can promote the caring relationship necessary for optimum adjustment to this type of procedure. Awareness of the problems experienced by TPE patients and knowledge of how to deal with such problems are essential if the nurse as a permanent figure in the health care system is to effectively direct patients' toward an adjustment that fosters realistic goals and satisfying living.