Penile and urethral cancers are very rare. Treatment for such cancers typically involve the removal of part or all of the urethra or penis. Such surgeries, while they prolong life, can be devastating psychologically.
What is penile and/or urethral preservation surgery?
Penile and urethral preservation surgery limits the amount of tissue removed and maximizes penile tissue preservation without compromising cancer control. The primary goal of penile sparing surgery is to preserve or regain sufficient tissue to allow voiding while standing up and/or sexual performance. Another goal is to avoid the disfigurement and profound negative quality of life that are the side effects of penis and urethral removal surgery.
For lower stage and grade cancers, penile preservation procedures are :
- circumcision (lesion confined to foreskin)
- topical chemotherapy (only for superficial cancers)
- laser ablation
Penile preservation surgical methods are:
- glans (head of the) penis resurfacing
- partial removal of the glans penis (head)
- removal of the entire glans penis and reconstruction
- Mohs micrographic surgery and reconstruction
- reconstruction of the penis stump
What if I need an inguinal lymph node dissection?
Inguinal lymph node removal for penile cancer is often complicated by skin swelling, leg swelling, skin infection, and occasional skin necrosis (dead skin). There are however, methods to reduce the side effects of a groin dissection. Specific surgical methods are:
- modified surgical template: This method involves takIng out fewer lymph nodes and in a more limited area.
- dynamic sentinel lymph node biopsy: This method has been extensively used in melanoma skin cancers and is now being done successfully with cancers of the penis.
- video endoscopic inguinal lymph node removal: This minimally invasive surgical method avoids the large incisions and many of the side effects of open surgery.