Penectomy

Abnormal cell growth (tumour) that starts in the penis is called penis cancer. If a tumour has grown into surrounding tissue, removing it surgically is the best chance of cure. If the tumour is in your penis tissue, some or all of your penis might need to be removed (penectomy) to get rid of the cancer.

Penectomy is also a treatment option for primary urethral cancer, depending on the tumour location and the involvement of adjacent tissue.

A recommendation of penectomy raises many questions. Talk with your doctor about your concerns, for example:

  • Are there other treatment options?
  • Will this cure my cancer?
  • What will my penis look like?
  • How long will it take to heal?
  • How will I urinate?
  • Will I be able to have sex?
  • Is reconstructive surgery an option?

Penectomy procedure

Removal of just the head of the penis is called a glansectomy (Fig. 1). If only the end of the penis will be removed, the surgery is called a partial penectomy (Fig. 2).

The surgeon will remove the end but leave as much of your penis as possible. A new end will be built using a skin graft from your thigh. If possible, your penis will be long enough for you to urinate standing up.

Fig. 1: Glansectomy.
Fig. 1: Glansectomy.
Fig. 2: Partial penectomy.
Fig. 2: Partial penectomy.

Total penectomy is removal of the whole penis. This includes the shaft and the root, which is inside your body. Also, a new opening may be created surgically to pass urine out of the body. This opening is usually placed on the perineum—the space between your scrotum and anus—between your legs.

Life After Treatment

After penis cancer treatment, your doctor will schedule you for regular visits to check your progress. Visits will be more frequent in the first year or two after surgery and then less often over time.

Your doctor will talk with you about how you’re feeling and any symptoms or concerns. A physical exam will look at your penis and check for new signs of cancer (recurrence).

You should examine your penis and lymph nodes regularly (self-examination). Get to know what is normal for you. Contact your doctor if you notice changes.

Sex

A satisfying sex life is part of your quality of life after penis surgery. Your doctor will consider this in recommending treatment. And surgery will preserve as much of your penis as possible. The type of treatment you have will affect your sex life after penis cancer.

Partial penectomy will preserve as much of the penis as possible. Many men are still able to have an erection and perform penetrative sex after surgery.

The whole penis may be removed to treat penis cancer that has spread to other tissue. You can have a fulfilling sex life after total penectomy, but it will likely be different. Your scrotum, testicles, and perineum will still be sensitive, and orgasm may be possible. Explore new ways to be sexual with your partner.