Penectomy for the Treatment of Penile Cancer

Penectomy is the surgical procedure to remove all or part of the penis. This procedure is mainly used as treatment against penile cancer.

Penile cancer is a collection of malignant, or cancerous, cells either inside or on the surface tissue of the penis.

Removing the penis is a procedure that isn’t undertaken lightly because it has both physical and psychological consequences. Doctors may recommend the procedure, either full or partial, if your situation warrants it. Although it’s mainly used if you have penile cancer, in rare cases it might be recommended following severe penile trauma.

Surgical procedures

If penectomy is recommended, the surgery can involve different techniques. It can be total or partial, and may include additional procedures.

Total penectomy involves the removal of your whole penis. In this case, surgeons will create a new urinary opening in the perineum. The perineum is the area between the scrotum and the anus. This is known as a perineal urethrostomy.

Partial penectomy removes the end of your penis, but leaves the shaft intact.

Both procedures may be done under either general or spinal anesthesia, meaning that you either sleep through the operation or remain awake but are totally numb in the area of the surgery.

Further steps that may be necessary include removal of the testicles and scrotum, and the lymph nodes. Surgery to remove the penis and testicles is known as emasculation, but this is typically done only in the case of very advanced cancers.

In certain situations, such as the cancer invading deep tissue, it may be necessary to remove some of your lymph nodes.

To assess whether or not the sentinel lymph node is affected, doctors will inject a radioactive dye close to the cancer. The sentinel lymph node is the first node to which cancer is likely to spread. When that dye is seen at a lymph node, the lymph node is removed and evaluated.

Depending on the results, if cancer is found, other lymph nodes will also be taken out. If no cancer is found, further surgery isn’t required.

Testing of the lymph nodes in the groin requires an incision to be made into the groin so the lymph nodes can be extracted for evaluation.

A stage 1 cancer offers various options for treatment. This may include circumcision, if tumors are just in the foreskin, or a more thorough surgery, such as:

  • Mohs surgery
  • wide excision
  • partial penectomy

Further options may be radiation therapy or laser ablation.

Recovery from surgery

Immediately following penectomy surgery, whether total or partial, you’ll usually need a short stay in the hospital, typically only one or two nights. It’s possible that a temporary catheter will be fitted to drain your bladder. The hospital will give you instructions on how to use and care for your catheter, if needed.

If you have a partial penectomy, you should still be able to urinate through the remaining penis while standing up. A total penectomy creates a new urinary opening in the perineum. This will mean that you have to sit down to urinate.

You’ll be given medications to prevent blood clots, infections, and constipation. Your doctor will also prescribe medication to help manage your pain. Your doctor will also give you advice on activities to avoid. Follow their recommendations to improve your recovery.

You may need a friend or family member to take care of daily tasks initially while you recover. Let your helper know what things you aren’t able to do and what help you need.

If you can’t find someone who’s available to help you out fulltime, consider asking a few people to help who can assist you in shifts.