Can a penectomy help treat penile cancer?

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A penectomy is an operation that surgeons use to remove part or all of a person’s penis. The ACS states that penectomies are the most common procedure for people who have cancer deep inside their penis.

The aim of a penectomy is to completely remove the cancer from a person’s penis. This may mean that a surgeon has to also remove some healthy tissue from the area. However, a surgeon will try to save as much penile tissue as possible.

There are three types of penectomy a person can have:

• Partial penectomy: A partial penectomy involves a surgeon removing the end of a person’s penis. A person who has a partial penectomy will have part of their shaft remaining. The shaft is the body of the penis.
• Total penectomy: Total penectomies involve a surgeon removing the entire penis. A surgeon may consider this option if there would not be enough shaft remaining for a person to urinate standing up without dribbling.
• Radical penectomy: A radical penectomy is similar to a total penectomy. However, in a radical penectomy, the surgeon also removes parts of the penis that are inside a person’s body.

The United Kingdom’s British Association of Urological Surgeons (BAUS) notes that surgeons use the following steps when performing penectomies:

1. A doctor will normally place a person under general anesthetic before the surgery begins. A person may also receive a dose of antibiotics. This can reduce a person’s chances of infection.
2. The surgeon cuts away any tumors from the penis. This may involve a partial, total, or radical penectomy.
3. If a person has a partial penectomy, the surgeon may take skin from the person’s thigh to attach to the remaining penis.
4. The surgeon will pass the urethra through the skin graft on the shaft of the penis during a partial penectomy.
5. During a total or radical penectomy, a surgeon makes a new hole for a person to urinate through. This new hole is located on the perineum. The perineum is the area between a person’s scrotum and anus.
6. After closing up the wound, a surgeon places a catheter inside a person’s urethra. This allows a person to urinate while their wounds heal.
7. The surgeon applies a firm dressing to the wound to reduce bruising and swelling during healing.

A penectomy can affect a person’s self-image. A person’s doctor may try and use treatments that avoid penectomies where possible. Other possible treatments for penile cancer can include:

Circumcision

A circumcision involves a surgeon removing a person’s foreskin. The foreskin is the loose skin at the tip of the penis. A surgeon may also have to remove some additional skin from the area. A circumcision can be an effective option to treat people who have cancer only in the foreskin.

Simple excision

During simple excision surgery, the surgeon removes any tumors from a person’s penis. The surgeon may also remove some nearby healthy tissue. If the tumor is small, a surgeon can sew up the remaining skin. A surgeon can use skin grafts for larger wounds.

Wide local excision

A wide local excision is similar to a simple excision. However, during the procedure, the surgeon removes a large amount of healthy tissue. This is to ensure the removal of all the cancerous cells.

Mohs surgery

Mohs surgery involves a surgeon cutting out a piece of tissue that may have cancer cells. The surgeon immediately analyses the sample. If there are cancer cells present, the surgeon cuts out another area of tissue. The surgeon repeats this process until all the cancerous tissue is removed.

Although it is a slow process, Mohs surgery allows a surgeon to save more healthy tissue. It can treat cancers that occur on the top layer of skin or have not grown deeply into the penis.

Glansectomy

The glans is the tip of the penis. If a person only has cancer in their glans, a surgeon can cut all or some of it off. They can then use a skin graft to repair the area.

Lymph node surgery

Lymph node surgery involves a surgeon removing lymph nodes near a person’s penis. A doctor may suggest this treatment in addition to a penectomy.

The lymph nodes filter foreign substances out of lymph fluid. Lymph fluid is a substance that carries white blood cells around the body.

Lymph node surgery allows a doctor to check whether a person’s cancer has spread to the lymph nodes. A doctor may suggest this surgery when a person’s cancer has grown deep inside the penis. A surgeon can remove any lymph nodes that contain cancer cells.

According to the BAUS, a person may experience swelling or bruising for several days following a penectomy. A doctor may also prescribe antibiotics or pain medication for after the surgery.

If a person has a skin graft during their penectomy, a healthcare professional will remove their dressing after 5–10 days. They will remove a person’s catheter once their wounds have healed or the skin graft has “taken.”

There are certain complications that may occur after a penectomy. The BAUS notes that a person may experience the following:

• a degree of impotence
• a shorter penis
• spraying urine during urination
• skin graft failure
• reoccurrence of cancer in the penis
• narrowing of the urethra opening
• infection

A penectomy is a procedure a doctor can use to treat penile cancer. The procedure involves a surgeon removing cancerous tissue by partially or completely removing the penis. It can be an effective treatment option, but surgeons will typically try other treatment options first.