Penile Reconstruction in Carcinoma Penis

Abstract

Introduction: Surgical management for penile carcinoma is mutilating and affects significantly the quality of life. Penile reconstruction restores the quality but poses a difficult challenge for the surgeon.

Aim: To report outcomes of patients with penile cancer treated surgically in a tertiary centre.

Materials and Methods: We reviewed data on all patients undergoing surgical management of penile cancer at a tertiary referral centre; Medical College Hospital Trivandrum, Kerala; between 2012 and 2016. Patients underwent surgical procedures like glansectomy, partial or total penectomy with different types of reconstruction depending upon the clinical stage of the disease.

Results: Between 2012 and 2016, a total of 36 patients presenting with penile cancer underwent surgical treatment. Seven patients with a mean age of 52 (27–69) underwent penile preserving surgery with glansectomy and skin grafting for small glanular lesions. Of the remaining 29 patients who underwent surgery, 21 had partial while 7 had total penectomy with perineal urethrostomy and one patient was managed by circumcision alone, who was having verrucous carcinoma. Mean followup for patients was 24 months (range 10–46). There were no graft failures in our series. Four patients developed meatal stenosis requiring dilatation.

Conclusion: Efforts to preserve penile length and function in the surgical treatment of penile cancer should be made in all suitable patients. Penile preserving surgery with glansectomy and skin grafting is a successful technique with minimal complications for local control of penile carcinoma arising on the glans. Further reconstructive procedures should be offered to the suitable patients at a tertiary centre like ours.