Penectomy

Penectomy

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 to get rid of the cancer.

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?

The procedure

If only the end of the penis will be removed, the surgery is called a partial penectomy (Figure 1). Removal of just the head of the penis is called a glansectomy (Figure 2) The surgeon will remove the end but leave as much of your penis as possible. A new end may 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: Partial penectomy
Fig. 1: Partial penectomy
Fig. 2: Glansectomy
Fig. 2: Glansectomy

Total penectomy is removal of the whole penis. This includes the shaft and the root, which is inside your body. Also, a new opening must be created surgically to carry 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

Follow-up

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.

Men treated for CIS and stage 1 penis cancer can usually continue their sex lives as before.

Partial penectomy for stage 2 or 3 penis cancer 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 stage 3 or 4 penis cancer. 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.

An erection might be possible after penis reconstruction surgery. It will depend on whether your nerves and blood supply can be reconnected. Ask your surgeon about what results are possible.

Recurrence

Sometimes penis cancer comes back after treatment is complete. This is called recurrence. Your doctor will check for recurrence during your follow-up visits. Regular self-examination will also help catch recurrence early.

Treatment is based on your previous type of treatment and the location of the new cancer:

  • On the penis: surgery to remove cancer cells, possibly followed by radiation therapy
  • In the lymph nodes: surgery to remove the lymph nodes and/or radiation therapy or chemotherapy
  • In other tissues or organs: chemotherapy or radiation therapy to shrink tumours