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Reconstructive surgery in penile trauma and cancer

Nature Clinical Practice Urology volume 2, pages 391–397 (2005)Cite this article

Abstract

This article provides an overview of the current concepts in reconstructive surgery following penile trauma, penile fracture and penile cancer. It covers the initial management of penile trauma, with the aim of preservation of as much viable tissue as is practical, and also provides advice on dealing with penile avulsion and amputation injuries. The best treatment for penile fracture—immediate surgical exploration and repair—is outlined and discussed. Finally, penile cancer management is reviewed, from initial biopsy to definitive treatment of the penile lesion—including wide excision, partial glansectomy, total glansectomy, and partial and total penectomy. It is concluded that appropriate surgery in all these conditions reduces subsequent long-term problems in sexual function, cosmesis, psychology, and (in cancer cases) longevity. The same reconstructive techniques can be applied for different penile conditions, and it is suggested that surgeons become experienced in genital surgery as a whole, rather than in oncology or trauma alone.

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Figure 1: Self-inflicted penile amputation.
Figure 2: Formation of a pseudo-glans with split-skin graft.
Figure 3: Typical appearance of a fractured penis.
Figure 4: Tunical rupture identified after degloving.
Figure 5: Penile MRI after intracavernosal alprostadil demonstrating a stage T2 tumor isolated to the glans.
Figure 6: The glans cap is dissected off the corpora.
Figure 7: Pseudo-glans formation with a split-thickness skin graft.
Figure 8: End result of glansectomy and pseudo-glans formation.

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Author information

Authors and Affiliations

  1. Consultant Urologist at Leicester General Hospital, Leicester, UK

    Duncan J Summerton

  2. Consultant Uroandrologist St Peter's Andrology Centre and Institute of Urology, University College London, London, UK

    Alistair Campbell, Suks Minhas & David J Ralph

Authors
  1. Duncan J Summerton
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  2. Alistair Campbell
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  3. Suks Minhas
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  4. David J Ralph
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Correspondence to David J Ralph.

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The authors declare no competing financial interests.

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Summerton, D., Campbell, A., Minhas, S. et al. Reconstructive surgery in penile trauma and cancer. Nat Rev Urol 2, 391–397 (2005). https://doi.org/10.1038/ncpuro0261

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