Penile Cancer and Partial or Total Penectomy

Partial or Total Removal of the Penis

Doctor talking with senior patient in office
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The American Cancer Society estimates that about 1,530 new cases of penile cancer will be diagnosed this year. 280 American's will die of penile cancer in 2006. Penis cancer is very rare in North America and Europe (0.2% of men) but is much more common in some parts of Africa and South America, where it accounts for up to 10% of cancers in men. Statistics on partial or radical penectomy following trauma are unknown.

Partial and Total Removal of the Penis

A penectomy to remove part (partial penectomy) or all of the penis (known as a radical or total penectomy) may have to be carried out if other treatments are not appropriate or have proved ineffective. In cases of cancer of the penis, the lymph nodes in the groin may also be removed. Removing lymph nodes can help prevent further spread of cancerous cells in the body.

Partial removal of the penis involves removing just the tip or head of the penis. The surgeon aims to save as much of the shaft of the penis as possible. This assists with urination by allowing the stream of urine to be directed away from the body.It also means that men can pass urine standing up in public washrooms and so maintain previous habits and routines.

Total (radical penectomy) removes the entire penis. This includes the parts of the penis that extend into the pelvis. Passing urine is achieved by creating a new opening for the urethra, the tube that carries urine from the bladder.

Sex and Intimacy Following a Partial Penectomy

Partial penectomy where the surgeon leaves part of the penis intact is obviously preferable if the condition or disease allows. After a partial penectomy, even though the most sensitive part of the penis, the head or glans is removed, an enjoyable and full sex life is possible.

Penetration can be achieved even with 3cms of shaft. This allows a man to achieve an erection when sexually excited and have a normal ejaculation.

Open, frank and supportive communication with your sexual partner is vital. Professional support may help facilitate this.

Sex and Intimacy Following Total Surgical Removal of the Penis

Men who have a total penectomy have to rethink the expression of their sexuality. Many men who have to have all of their penis removed are older so this may not be as important to them as the more practical issues such as bladder control.

For younger men having a good sex life is usually very important. Open communication with a partner willing to explore how to achieve this is vital. You have to consider this in a number of ways:

  • The exploration of sensation in the genital area. This can be achieved through massage, use of a vibrator, through oral sex.
  • Improving sexual arousal (for both partners) may be helped through sexual fantasy using erotic literature and pictures.
  • Through experimentation, many men and their partners have a satisfying sex life.

Support Following Penectomy

Because cancer of the penis is a comparatively rare disease support from people who have had partial or total removal of the penis can be difficult to find locally.

Website support networks are available.

Sexual support therapists specialists are available nationally and can be accessed through the specialist cancer services. Many surgeons or hospitals will provide this information postoperatively. If not contact your local Government health Services department for advice, names, and contact numbers.

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