Penectomy is a surgical procedure used to remove part or all of the penile tissue. This treatment is primarily employed for conditions such as penile cancer, severe infections, trauma, or congenital abnormalities. The goal of the surgery is to excise malignant tissues, prevent cancer spread, or address severe structural issues, while preserving as much of the patient's physiological function and quality of life as possible.
The procedure is typically performed by urologists or oncologists and requires a tailored approach based on the extent of the lesion and patient needs. Postoperative reconstruction or adjunct therapies may be necessary to restore some functions or appearance.
Penectomy mainly divides into "partial" and "total" removal. Partial penectomy preserves part of the penile tissue and is suitable for early-stage cancer or localized infections; total penectomy involves removing the entire penis and is usually indicated for advanced cancer or cases with severe tissue damage. The surgery involves removing affected tissues and may include lymph node sampling to assess the risk of metastasis.
The surgical mechanism includes precise excision of diseased tissue, hemostasis, wound suturing, and may incorporate skin grafts or reconstructive procedures. If the patient requires erectile function, nerves and blood vessels are preserved as much as possible during the operation to facilitate subsequent functional recovery.
This therapy is mainly indicated in the following situations:
In some cases of congenital abnormalities, such as severe penile deformities or hypospadias, this surgery may also be considered to improve urination or sexual function.
The procedure is usually performed under general anesthesia, with the surgeon planning the excision extent based on the lesion location and scope. The steps include:
Postoperative care involves antibiotics to prevent infection and regular follow-up with tumor markers or imaging. If the patient undergoes chemotherapy or radiotherapy, treatment timing should be coordinated to ensure efficacy.
The direct benefits of penectomy include:
When combined with reconstructive surgery, it can improve appearance and some functions, while also reducing psychological impact. Early detection of cancer and subsequent surgery can increase the 5-year survival rate to over 70%.
Potential immediate risks include:
Long-term side effects may include: permanent loss of sexual function, penile shortening affecting urination, psychological trauma, or self-esteem issues. Patients require regular monitoring for tumor recurrence or complications.
Preoperative assessment of the patient's overall health, such as cardiopulmonary function and coagulation status, is essential. Contraindications include:
Postoperative care must follow strict guidelines, such as avoiding strenuous activity, daily wound cleaning, and regular follow-up. Psychological counseling is recommended to help cope with potential physical and mental impacts.
This surgery may be combined with chemotherapy or radiotherapy, for example:
If the patient is on anticoagulants or immunosuppressants, medication adjustments are necessary before surgery to reduce bleeding risk. Timing with other surgeries should also be coordinated to avoid impairing wound healing.
According to multiple international clinical studies, early-stage penile cancer patients undergoing curative resection have a 5-year survival rate of 80%-90%. Patients with localized excision and no deep tissue invasion have a recurrence rate below 20%.
The surgical efficacy is influenced by tumor stage and lymph node metastasis. Advanced cases may require combined radiotherapy or chemotherapy to improve overall outcomes. Long-term follow-up shows that patients with well-managed postoperative complications experience gradual improvements in quality of life.
Non-surgical options include:
The choice of alternative treatments depends on the malignancy grade, patient age, and overall health. The physician will determine the most suitable approach based on risk-benefit analysis.
The recovery period after penectomy generally lasts 4 to 6 weeks, depending on the extent of the surgery and individual health. During this period, avoid heavy lifting, prolonged walking, or cycling, and follow medical instructions for dressing changes. Keep the surgical site clean and dry to prevent infection. Wearing loose underwear is recommended to reduce friction.
What long-term side effects may occur after surgery? How can psychological impacts be managed?Long-term side effects may include changes in urination patterns or decreased sensitivity of surrounding tissues. Patients who undergo urinary diversion surgery need to adapt to new urination methods. Psychologically, it is advisable to communicate with professional counselors or support groups. Hospitals often provide psychological counseling resources to help patients and families adapt to lifestyle changes.
Are there alternative treatments before surgery? When is surgery necessary?If the disease is in early stages and has not invaded surrounding tissues, radiotherapy or medication may be attempted first. However, if the cancer has invaded deep tissues, lymph node metastasis, or recurred, surgery is usually necessary. The specific plan should be evaluated jointly by oncologists and urologists.
Can normal sexual function be restored after surgery? What supportive treatments are available?Surgery may affect erectile function, but some patients can partially recover through medication or physical therapy. Severe cases may consider penile prosthesis implantation or vacuum erection devices. The doctor will provide personalized advice based on tissue removal extent and nerve preservation status.
What are the key points for postoperative follow-up examinations? When should immediate medical attention be sought?Follow-up mainly involves monitoring tumor markers, imaging, and urine analysis to detect early signs of recurrence. If abnormal swelling, persistent bleeding, fever over 38°C, or severe urination obstruction occurs, seek medical attention immediately. Regular follow-up every 3 to 6 months for at least 5 years is recommended.
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