Penile Cancer

Preparation and anaesthetics

Preparing for Surgery

Having decided to be treated with surgery, men should receive a detailed explanation of the operation and how it may impact on their quality of life. Men will also be given information stating when and where the surgery will take place.
 
At the hospital patients will have pre-operative tests conducted. These may include:
  • Blood tests
  • A chest X-ray
  • An electrocardiogram (ECG)

For these tests to happen, the patient will usually have to go a hospital a week or more before their operation. When it comes to the operation, the man may need to arrive at the hospital early on the day, or the night before it is due to take place. Before going into the operating theatre, men will be visited by the surgeon, the anaesthetist, a nurse specialist and possibly a physiotherapist. In these pre-operative meetings, professionals will confirm that the patient understands what is happening, that they are aware of the risks and are happy to continue. The patient will also be given the opportunity to ask questions and discuss any concerns that they have about the procedure. Before surgery, men will have to sign a consent form stating that they give their permission for the operation to proceed. The surgeon can rarely be sure how much tissue they will have to remove until they begin the operation, therefore men may be asked to consent for more to be removed than actually at first planned.
Frosty had pre-operative tests on his heart and lungs a week before he was due in the hospital and further tests immediately before the operation. Men may feel anxious before surgery, and the day itself can be long and tiring; it is therefore important that men try to rest before going into hospital. Before surgery, Tim had several tests conducted on him, including a radioactive trace of his lymph nodes. This test allows the surgeon to see the flow of lymph fluid draining through the nodes, which indicates whether any nodes have been affected by the cancer.
Anaesthetics
Anaesthetics refer to a procedure that takes away your ability to feel pain and there are a number of types of anaesthetic. A ‘general anaesthetic’ will leave the patient unconscious for the duration of the operation. A ‘local anaesthetic’ will render the area of the body operated on completely numb for the duration of the operation. A ‘regional anaesthetic’, such as an epidural or spinal block where the anaesthetic goes into the spine, will block sensation below the point of administration. All types of anaesthetic can take several hours to wear off. Men undergoing surgery for penile cancer usually have a general anaesthetic or a regional anaesthetic. Before having a general or regional anaesthetic, it is necessary to refrain from eating and drinking for around six hours.
 
Many of the men we spoke to had their operations under a general anaesthetic. This can be administered by an injection into the arm, or by inhaling a gas through a mask. Some men, but not all, may experience side effects from a General Anaesthetic. Rodger talked about feeling slightly sick afterwards, but soon felt fine. After the operation, the man will be moved from the operating theatre to the recovery room, where they gradually come around following the operation.
In some cases, a general anaesthetic may have to be ruled out or may be less preferable than other types. For patients with pre-existing conditions that would be affected by a general anaesthetic, their specialist may recommend a regional anaesthetic. For example, the patient may have an epidural, which is where the anaesthetic is put into the spine via a very small tube called a catheter. Epidurals are often given after the man has swallowed a pill, called an anxiolytic, that helps them relax.

Simon had his first operation with a local anaesthetic. While he was fully conscious, he felt no pain and a screen blocked his view of what was happening. A local anaesthetic wears off quickly, which means that the man can return home, either the same day or by at least the next day after surgery.

Last reviewed January 2015.
Last updated January 2015.
 

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