Penectomy

What is a penectomy?

A penectomy refers to the surgical removal of the penis. You can have a partial penectomy or a total penectomy. The surgery is the most common way to treat cancer of the penis.

Why is a penectomy done?

A penectomy is a surgery to treat penile cancer. This rare cancer affects not quite 1 person in 100,000 in Europe and North America. Penile cancer is more common in some places in Asia, Africa and South America. Cancer of the penis is more common in males who:

• Smoke
• Aren’t circumcised
• Have HPV or AIDS
• Are older than 50 years of age
• Have been treated with UV light and psoralen for psoriasis
• Have foreskin issues like phimosis and secretions that collect under the foreskin (smegma)

What happens before a penectomy?

Before a penectomy, your provider will talk with you about your options. It’s important to find a surgeon who has experience in doing these kinds of procedures. The extent of your surgery depends on the extent of cancer. Your surgeon will be able to treat less invasive cancers by removing less tissue.

What happens during a penectomy?

If your tumor is large, invasive and likely to recur, you’ll need a partial or total penectomy.

If cancer is only at the tip, your surgeon can remove the tip (glans) in a glansectomy. The surgeon can perform a skin graft on the glans.

If your surgeon performs a partial penectomy, they’ll try to leave as much of the organ as they can. They will try to make it such that you can still stand to urinate (pee).

With a total penectomy, the entire penis, including the root that goes into the pelvis, is removed. In this case, the urethra (tube that allows urine to leave the body) will be rerouted to a spot in the perineum. This is the area between your scrotum and your anus. This is called a perineal urethrostomy. You’ll need to sit when you urinate.

If you’re having a penectomy because of penile cancer, your surgeon may remove lymph nodes to find out if cancer has spread.

Although it’s not possible in all cases, there is a chance that you might be able to have a phalloplasty or a penile reconstruction.

What happens after this procedure?

Your hospital stay may depend on the reason for the surgery you’ve had. After you’ve had a penectomy, you:

• May be in the hospital for two to three days
• Will have a urinary catheter in to drain urine for up to 14 days
• May have a tube to allow blood to drain from the wound
• Should be able to eat and drink as you wish
• Will have swelling that may take some time to heal

What are the advantages of penectomy?

If you have penile cancer, remember that this treatment will give you the best chance for survival.

What are the risks or complications of penectomy?

Every surgery comes with risks. Possible risks or complications may include:

• Urinary tract infection
• Excessive bleeding
• Infection at the site of surgery
• Lymphedema in your legs. You might also have fluid draining into the soft tissue of your scrotum.

What is the recovery time after a penectomy?

Every person recovers at a different rate. You should discuss the time frame with your provider before you have the surgery.

• You may be in the hospital for two to three days.
• You’ll be off of work for about a month.
• You shouldn’t lift anything heavy for four to six weeks.
• You may need to wear compression stockings or take medication or do both to prevent blood clots.
• The swelling should get better over several weeks.

How will a penectomy for cancer affect my sexuality during and after recovery?

As with many other topics, your physical ability to get and maintain an erection will depend on the type of surgery you’ve had. With a glansectomy and a partial penectomy, you may be able to have an erection and use your penis to have penetrative sex after you’ve had enough time to heal.

If you’ve had a total penectomy, it won’t be possible to engage in sexual activities that involve penetration. However, there are many ways that sexuality can be expressed and shared with your partner. It’s very important to be honest with each other and to talk things through.

You can speak with your provider about services that may be available you in terms of counseling and support.

When should I call my healthcare provider?

Call your provider if you:

• Develop a high fever
• Are bleeding excessively
• Have pain that’s not relieved by prescribed painkillers
• Are concerned about any new or worsening symptoms

A note from Cleveland Clinic

If you need a penectomy, seek out a surgeon who has a good reputation and experience in doing these surgeries. Get as much information as possible before you have the surgery so you know what to expect and how to prepare your home and your family and friends. Be open to the many types of post-operative services available to you.