A penectomy is an operation to remove all or part of a penis. This type of surgery is usually done as part of the treatment for cancer of the penis. It is an effective cancer treatment.
*What Is Penile Cancer?*
Penile cancer is cancer that occurs anywhere on the penis. . Penile cancer can be treated, and surgery is the most common treatment.
(Refer to our previous notes on penile cancer for more details)
*Types of Penectomy*
?Surgery is the most effective treatment for any type of cancer on the penis. Doctors will operate to remove cancer and any tissue surrounding it to prevent it from spreading. The extent of the surgery depends on how deep inside the penis the cancer has gone.
?In many cases, the cancer is confined to the skin, so doctors can just remove the top layers of the skin. Depending on where on the penis the cancer is located, doctors might remove only the foreskin, the glans, or a section of skin further down on the penis. After these operations, most men have normal sexual and urinary function.
?If cancer has moved into the tissue of the penis itself, doctors may need to remove all or part of the penis. This procedure is called a penectomy. There are three types of penectomies:
Partial Penectomy. Doctors will remove the head of the penis and any affected parts of the shaft. Doctors usually try to leave as much of the shaft in place as possible to ensure that the patient can still urinate standing up and some sexual function remains.
?Total penectomy.
If doctors can’t save the shaft of the penis, they will remove the whole organ. They will also remove the roots of the penis that extend up into the pelvic area. Doctors move the urethra to the space between the testicles and the anus. The patient will be able to control urination, though they will have to sit to urinate. Sexual intercourse is no longer possible. Sometimes, doctors can perform reconstructive surgery after a total penectomy.
?Emasculation.
Very rarely, cancer spreads to such an extent that doctors have to remove the scrotum and testicles as well as the penis. Since the testicles produce most of the testosterone in the body, any man who has had this operation will need to be on hormone replacement therapy for the rest of his life.
*Life After a Penectomy*
?Penis removal is a drastic change to your life. Not only do you experience the fear and stress that comes with a cancer diagnosis, but the emotional impact of losing your penis is dramatic.
? Doctors and therapists will be able to help you manage your feelings about the changes to your body.
?You may need to change the way you urinate or sit to urinate after a penectomy. If you have enough penis remaining to stand for urination, you may need to adjust how you position yourself and learn new ways to keep your penis clean.
?Many people can continue to enjoy pleasurable sexual activities after partial penectomy. They can still have erections when they are aroused. If the testicles are still present, they can have orgasms as well.
?You cannot have sexual intercourse after total penectomy. However, if the scrotum and testicles are still present, you may be able to learn to orgasm from other kinds of stimulation. Being open with a trusted partner is an essential step in learning how to have sex after a penectomy.
*What Is Penile Cancer?*
Penile cancer, or cancer of the penis, is when cells grow out of control on or in a man’s penis. It often starts in skin cells and can work its way inside.
*Types of Penile Cancer*
?Squamous cell or epidermoid carcinoma. This makes up 95% of penile cancer cases. It usually starts on or under your foreskin but can also appear on other parts of your penis.
?Sarcoma.
These cancers form in tissues like blood vessels, muscle, and fat.
?Melanoma.
This is cancer that starts in the cells that give your skin color.
?Basal cell carcinoma.
These cancers start deep in your skin. They grow slowly and aren’t likely to spread to other areas of your body.
*Penile Cancer Causes and Risk Factors*
Experts don’t know exactly what causes penile cancer. Research shows that it’s more common in men who:
?Have the human papillomavirus (HPV)
?Are over age 60
?Smoke
?Have a weakened immune system because of HIV or AIDS
?Aren’t circumcised. Fluids and a thick buildup called smegma can collect under your foreskin and might make cancer growth more likely.
?Have a condition called phimosis, which makes your foreskin tight and tough to clean. It can also lead to fluid buildup.
?Had psoriasis treatment with the drug psoralen and ultraviolet (UV) light
*Signs and Symptoms of Penile Cancer*
?Changes in penis skin are the most common symptom of penile cancer. They can show up on the foreskin of uncircumcised men, on the penis tip (the glans), or on the shaft.
Symptoms of penile cancer include:
?Changes in skin thickness or color
?A rash or small crusty bumps on your penis; it can look like an unhealed scab.
?Growths that look bluish-brown
?A lump on your penis
?A bad-smelling discharge underneath your foreskin
?A sore on your penis, which may bleed
?Swelling at the end of your penis
?Lumps under the skin of your groin
These signs don’t always mean penile cancer. You might have an infection or an allergic reaction. But it’s important to tell your doctor about any unusual symptoms on or near your penis right away.
*Penile Cancer Diagnosis*
Your doctor will give you a physical exam and ask you about your symptoms. They may recommend other tests, such as:
?A biopsy. Your doctor takes a small sample of tissue from a skin lesion on your penis. Lab tests check it for cancer cells.
?Imaging tests, like X-rays, CT scans, ultrasounds, and magnetic resonance imaging (MRI). These look inside your body for tumors or other signs that cancer has spread.
*Penile Cancer Treatment*
If your cancer is in the early stages, your treatment may include:
?A medication in the form of a cream for your skin
?Cryotherapy, a procedure that uses an extremely cold liquid or a device to freeze and destroy cancerous tissue
?Mohs surgery, in which doctors remove affected skin one layer at a time until they reach healthy tissue
?Lasers to cut and destroy areas that contain cancer
?Circumcision, which is surgery to remove your foreskin. You would have this procedure if you had cancer only in your foreskin.
If your cancer is further along or more likely to spread, you might also have:
?Surgery to remove some or all of the lymph nodes in your groin if your cancer has spread there
?Radiation and/or chemotherapy to rid your body of cancer cells
?A penectomy, which is surgery to remove some or all of your penis
Most treatments for early-stage penile cancer don’t affect your ability to have sex, but chemotherapy and radiation might. Talk to your doctor about possible side effects.
*Penile Cancer Prevention*
There’s no one way to prevent cancer, but some things can lower your risk:
?Have a circumcision. When you don’t have a foreskin, it’s easier to keep the area clean.
?If you have a foreskin, make sure to carefully clean underneath it.
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