Penile Cancer

Types of surgery

Surgery is the main method of treatment for penile cancer; radiotherapy and chemotherapy are rarely used (see ‘Additional treatments’). There are several types of operation for penile cancer, and which operation a man will have depends on the size and location of the cancer.
As the doctors can’t be sure of the extent of the cancer until they cut into the penis, there are times when the surgeon has to cut out a larger amount than initially expected. It is usual for the doctor to discuss this possibility with the man beforehand.
 
The main types of surgery to the penis are as follows:
 
  • Circumcision: If the cancer is small and affects only the foreskin, it may be possible to treat it by performing a circumcision (which is an operation to remove the foreskin and thereby leave the head of the penis uncovered). This is a small operation usually taking less than an hour, that may be undertaken using either local, regional or general anaesthesia.

  • Local excision: If the cancer is small and affects the head of the penis (the glans) it may be possible to perform a wide local cut or ‘excision’. This involves removal of the tumour together with a margin of healthy tissue around the cancer. This is a small operation, usually taking less than an hour, and is performed under regional or general anaesthesia.

  • Glansectomy: For some cancers located on the head of the penis (the glans), just that part can be removed (a glansectomy) while retaining as much as possible of the shaft of the penis; the head of the penis can be reconstructed with a skin graft. This is an operation that usually takes less than two hours, and is performed under regional or general anaesthesia.

  • Partial Penectomy: If the cancer is larger, then part or all of the shaft of the penis will need to be removed along with the head (a partial penectomy). This is an operation that usually takes less than an hour, and is performed under regional or general anaesthesia.

  • Total Penectomy: Removal of the whole penis, or ‘total penectomy’, is necessary if the cancer is located deep inside the penis or at its base. It is not usually necessary to remove the scrotum or the testicles. The urethra (tube through which the urine passes) will be redirected to a new opening, usually behind the scrotum and in front of the anus. This is an operation that usually takes around two hours, and is performed under regional or general anaesthesia. It may be possible to reconstruct the penis at a later date using tissue from elsewhere in the body.

  •  
The length of time taken to undertake penile cancer surgery, and to recover from it, can vary considerably depending on which operation is done (see also ‘Recovery from surgery). For instance, Big D had a circumcision and removal of a lump from his penis and was sent home the next day, whereas Mark was under anaesthetic for nearly eight hours for a total penectomy and stayed in hospital for several days. Some surgical procedures will be quicker and easier than others, but each operation is unique.
Men who have had a glansectomy or partial penectomy may have the end of their penis reconstructed either at the same time or in a later operation. If there is insufficient skin available around the penis, the surgeon can take skin, in what is called a ‘skin graft’, from other parts of the body, commonly from the thigh, to cover the end of the penis. The main purpose of this reconstruction is to improve the cosmetic appearance of the penis. When this is done, there will be a dressing on the penis for around 1 week and another dressing on the thigh for around 2 weeks. The patient will usually need to wear a catheter for a week or so (see ‘Using the toilet after penile cancer surgery’).
 
Some of the men we spoke to talked about experiencing problems with the skin graft. David found it awkward keeping the dressing on his thigh. He solved this problem by using a pair of tights to keep the dressing in place.
 
Reconstructive surgery is sometimes possible after a total penectomy by using tissue taken from the forearm to create a ‘new’ penis. When we spoke to Mark, he was awaiting a decision from his specialist as to whether this might be possible in his case.
Among the men we interviewed, several had undergone more than one operation to treat their cancer. Some men may need multiple operations before all the cancer is successfully removed. For instance, at first Colin had the end of his penis (the glans) removed and it was reconstructed with a skin graft. However, subsequently more cancerous lumps developed in the penis so he went on to have a total penectomy. Other men had reconstructive work done in a separate operation (as mentioned above). Because penile cancer may spread to the lymph nodes in the groin and beyond, additional surgery may also include removal of one or more lymph nodes (see ‘Lymph node removal’).
 
Further information resources on surgery

Last reviewed January 2015.
Last updated January 2015.

Feedback

Please use the form below to tell us what you think of the site. We’d love to hear about how we’ve helped you, how we could improve or if you have found something that’s broken on the site.

Make a Donation to healthtalk.org





Find out more about how you can help us.

Send to a friend

Simply fill out this form and we'll send them an email