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Functional outcomes of organ sparing surgery for penile cancer confined to glans and premalignant lesions

International Journal of Impotence Research volume 37, pages 736–744 (2025)Cite this article

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Abstract

The first-line treatment of penile cancer confined to the glans (Tis-T2) is based on organ-sparing approaches. Our aim is to report functional outcomes of total glans resurfacing (TGR), wide local excision (WLE) and glansectomy. A retrospective analysis was conducted from January 2013 to October 2022. Ninety-nine patients were enrolled (22 TGR, 29 WLE, and 48 glansectomy). Sexual and urinary outcomes were explored using ad hoc and validated questionnaires (IIEF-15 and IPSS). The mean follow-up was 25.28 ± 24.87 months [95% CI: 20.38; 30.18]. 44 patients (12 TGR, 10 WLE, and 22 glansectomy) were assessed for functional outcomes. Overall, 86.36% of patients were satisfied with the surgery. The mean IIEF-15 score pre-operation was 54.91 ± 21.38 [95% CI: 48.41–61.41], and at 12 months post-operation, it was 44.39 ± 23.01 [95% CI: 37.39–51.39], with the change being statistically significant (mean difference: –10.52, (–19.15), p < 0.001). During the 0–12-month interval, IIEF-15 scores decreased across all techniques. Glansectomy and WLE showed significant decreases (Glansectomy: –12.955, –24.14%, [95% CI: –21.52, –4.38], p = 0.002; WLE: –14.1, –22.92%, [95% CI: –26.8, –1.39], p = 0.025 respectively), whereas TGR experienced a non-significant decrease (–3.083, –5.97%, CI: [–14.68, 8.51], p = 1.0). Concerning urinary function, only 18.18% of overall patients reported a negative impact of surgery. At 12-months, patients returned almost to pre-intervention IPSS values. Organ-sparing surgery guarantees a decent preservation of both erectile and voiding functions. TGR seems to provide better sexual outcomes when compared to other organ sparing approaches.

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Fig. 1: Line graphs depicting perioperative and postoperative total IIEF-15 scores, as well as scores for individual IIEF-15 domains, in patients undergoing organ-preserving surgery are presented.
Fig. 2: Line graphs illustrating preoperative and postoperative IPSS values in patients undergoing organ-preserving surgery are presented.

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Data availability

The data that support the findings of this study are available from the corresponding author (M.F.) upon reasonable request.

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Authors and Affiliations

  1. Urology Clinic—A.O.U. “Città della Salute e della Scienza” – Molinette Hospital, University of Turin, Turin, Italy

    Marco Falcone, Mirko Preto, Martina Scavone, Lorenzo Cirigliano, Federica Peretti, Ilaria Ferro, Natalia Plamadeala & Paolo Gontero

  2. Neurourology Clinic—A.O.U. “Città della Salute e della Scienza”—Unità Spinale Unipolare, Turin, Italy

    Marco Falcone

  3. Department of Urology, Biruni University School of Medicine, İstanbul, Turkey

    Marco Falcone

  4. Department of Urology, Selcuk University School of Medicine, Konya, Turkey

    Murat Gül

  5. Selcuk University School of Medicine, Konya, Turkey

    Ali Şahin

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Contributions

MF, MP, and PG designed the experiments and helped supervise the project. MF, MG, AS, and MS wrote the manuscript and performed the computations. MG and AS verified all the statistical analyses. MS, LC, FP, IF, and NP participated in data collection. All authors discussed the results and contributed to the final manuscript.

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Correspondence to Marco Falcone.

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The author declares no competing interests.

Ethics approval and consent to participate

We declare that all methods were performed in accordance with the relevant guidelines and regulations. The study was authorized by the local ethics committee (N°00235/2021). We declare that each patient provided informed consent to undergo the surgical procedure and to authorize the publication of their data. Written informed consent was obtained for taking photos in the operating room and for the publication of these images. This consent is separate from the consent to participate in the study.

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Falcone, M., Preto, M., Gül, M. et al. Functional outcomes of organ sparing surgery for penile cancer confined to glans and premalignant lesions. Int J Impot Res 37, 736–744 (2025). https://doi.org/10.1038/s41443-024-00967-7

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