Penectomy: Surgery, Risks, And Outlook

Penile cancer is an uncommon cancer that may lead to serious and deleterious complications. In severe cases, the cancer is managed by surgical removal of penis, by a procedure known as penectomy. Based on the latest data released by American Cancer Society, it has been estimated that 2,100 cases of penile cancer will be reported in the US by 2017. Although an uncommon malignancy in Europe and US, the penile cancer occurs more frequently in some Asian countries, South America, and parts of Africa. Several histological varieties are identified, such as adenocarcinoma, squamous cell, sarcoma, and melanoma.

What Should You Know About Penectomy?

There are 2 surgical varieties of penectomy; complete or partial – depending upon the involvement of deeper layers of penis, your surgeon may excise maximum diseased tissue, while leaving behind the normal tissue. In case of severe involvement, the procedure may involve complete removal of tip, shaft, root; and extending well into the pelvis as well.

In partial penectomy, the surgeon may just remove the tip of penis while leaving behind most of the penile shaft intact.

Other clinical indications of penectomy are:

• Moderate to severe traumatic injury of penis
• Formation of a growth in the deeper layers of penis

Adverse Effects Or Complications Of Penectomy

The risk of adverse effects or complications depends on several factors such as age of patient, extent of disease and nature of procedure performed. The complications may be temporary or permanent; mild or severe.

Surgery related complications include:

• Anesthesia complications
• Excessive bleeding
• Risk of infection

Procedure related complications include:

• Chronic pain or localized discomfort
• Infection of the wound site
• Narrowing or obliteration of urethra
• Formation of blood clots
• Inability to urinate in standing posture
• Obstruction or inflammation of lymph vessels leading to lymphedema
• Sexual dysfunction

What To Expect After Penectomy?

The outcome of this procedure depends mainly on the nature and severity of penile cancer, age of the patient, and tumor size. If tumor has spread to other parts of the body, the patient may need additional treatment. In case of localized disease, the results are often satisfactory after penectomy.

The procedure often changes the expulsion of urine from the body. In most cases, a new opening is created between the scrotum and anus to allow drainage of urine. If the disease, injury or cancer also involves the testicles, your surgeon will also remove the testicles, in which case it is recommended to acquire testosterone supplements.

Make sure to follow your doctor’s advice and keep up with the periodic check-ups. Some tips that may help expedite the recovery process are:

• A urinary catheter is usually introduced after the procedure to allow pain-free drainage of urine
• Avoid lifting heavy weights soon after the procedure
• Take all the antibiotics, analgesics and blood thinning medications advised by your doctor to hasten recovery.

References

• Mossanen, M., Holt, S., Gore, J. L., Lin, D. W., & Wright, J. L. (2016, December). 15 Years of penile cancer management in the United States: An analysis of the use of partial penectomy for localized disease and chemotherapy in the metastatic setting. In Urologic Oncology: Seminars and Original Investigations (Vol. 34, No. 12, pp. 530-e1). Elsevier.