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Penile and Inguinal Reconstruction and Tissue Preservation for Penile Cancer

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Advanced Male Urethral and Genital Reconstructive Surgery

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Penile cancer is a rare disease in North America, but it has considerable psychosocial and health consequences. Patients often present after a significant delay and, consequently, with advanced disease that typically requires ablative and amputative surgery. To minimize the disfiguring effects of such radical surgery, penile-sparing therapies have been employed for ≤T2 stage disease. Herein, we detail a number of tissue-preserving treatments that are available for penile cancer. For CIS and T1 disease, topical 5-FU and imiquimod, Mohs surgery, laser ablation, radiation (external beam or interstitial), or simple surgical excision is an effective option. For T2 disease, radiation, partial or total glansectomy, or partial penectomy is a mean to reduce disfigurement. While these treatments have a higher rate of local tumor recurrence than partial or total penectomy, they are not associated with worse survival. Reconstruction after a subtotal penectomy can be performed by penile advancement and skin grafting or replacement surgery with a sensate free flap. Sartorius muscle, rotational, and thigh flaps anatomy and mobilization techniques are also detailed. Penile-sparing therapies offer good cosmetic results and reasonable phallic length (to allow for urination while standing and the potential for sexual activity) without compromising oncologic control.

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Author information

Authors and Affiliations

  1. Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, 660 S. Euclid, 8242, St. Louis, MO, 63110, USA

    Steven B. Brandes MD

  2. Department of Urology, Massachusetts General Hospital, Boston, MA, USA

    Jairam R. Eswara MD

Authors
  1. Steven B. Brandes MD
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  2. Jairam R. Eswara MD
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Correspondence to Steven B. Brandes MD .

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Editors and Affiliations

  1. Department of Surgery Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA

    Steven B. Brandes

  2. Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA

    Allen F. Morey

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Brandes, S.B., Eswara, J.R. (2014). Penile and Inguinal Reconstruction and Tissue Preservation for Penile Cancer. In: Brandes, S., Morey, A. (eds) Advanced Male Urethral and Genital Reconstructive Surgery. Current Clinical Urology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-7708-2_46

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  • DOI: https://doi.org/10.1007/978-1-4614-7708-2_46

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  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4614-7707-5

  • Online ISBN: 978-1-4614-7708-2

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