Carcinoma of the penis surgery

Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Joel Gelman, M.D. [2], Director of the Center for Reconstructive Urology and Associate Clinical Professor in the Department of Urology at the University of California,Irvine

Surgery is the mainstay of treatment for carcinoma of the penis.

Surgery is the mainstay of treatment for penile cancer.^[1] Common types of surgery include:

• Circumcision

• A circumcision removes the foreskin of the penis. This may be all that is required for a very small tumour located only on the foreskin.

• Mohs surgery

• Mohs surgery is a specialized surgical method that may be used to treat small, early stage penile cancers. It is used to remove the tumour and surrounding tissue layer by layer, until the tissue is completely clear of cancer cells.

• Wide local excision

• Wide local excision is used to treat very small, early stage penile cancers. The tumour is removed along with a margin of normal tissue around it. The remaining skin is stitched together. The rest of the penis is left intact.

• The standard margin around the tumour used to be 2 cm, but recent data suggest that such a wide margin may not be necessary. Sometimes a 1 cm margin around the tumour is enough to prevent the cancer from coming back. The margin size may vary depending on the grade, type and size of the tumour.

• This surgery may need to be followed by external beam radiation therapy, brachytherapy, laser surgery or more extensive surgery.

• Penectomy

• A penectomy is surgery that removes part or all of the penis. It may also be referred to as a partial or total amputation of the penis. A penectomy is the most common and effective surgery done to treat cancer that has spread deeply into the tissues inside the penis.

• Lymph node removal

• Lymph node dissection
• Sentinel lymph node biopsy

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