✦ Penile Cancer Treatment

Inguinal Lymph Node Dissection (Superficial + Deep)

Q: What are the complications of inguinal lymph node dissection?

Wound infection, skin flap necrosis, lymphoedema of the legs, lymphocele, and deep vein thrombosis are known complications; careful technique minimises risk.

Q: Is sentinel node biopsy an alternative to full dissection?

Dynamic sentinel node biopsy (DSNB) is recommended for cN0 high-risk patients to identify occult nodal metastasis before full dissection.

Q: What is the prognosis after node-positive dissection?

5-year survival exceeds 85% for N1, 60% for N2, and 30–40% for N3 disease; early surgery before nodal fixation significantly improves outcomes.

Surgical Removal of Inguinal Lymph Nodes for Penile Cancer Staging and Cure

120–180 min PROCEDURE

3–5 Days HOSPITAL STAY

>85% node-negative SUCCESS RATE

4–6 Weeks RECOVERY

What is Inguinal Lymph Node Dissection (Superficial + Deep)?

Inguinal Lymph Node Dissection (ILND) for penile cancer removes the superficial and deep inguinal lymph nodes — the primary lymphatic drainage of the penis. It is performed for palpable inguinal nodes confirmed to be metastatic, or as sentinel node biopsy/modified dissection in high-risk non-palpable cases. Bilateral dissection is performed as penile lymphatics drain to both groins. Adequate ILND is the most important determinant of long-term survival in nodal penile cancer. The procedure is performed under general or spinal anaesthesia with a hospital stay of 3–5 Days.

Patients with penile cancer and palpable inguinal nodes, high-risk tumour features (T2+ or grade 3), or positive sentinel node biopsy requiring therapeutic lymph node dissection. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Incision & Access

Bilateral groin incisions; deep inguinal fascia opened.

Superficial Node Dissection

Superficial inguinal nodes (within Camper's fascia) dissected en bloc.

Deep Node Removal

Deep inguinal nodes (below fascia lata, medial to femoral vein) removed.

Pelvic Extension

Pelvic node dissection added if deep inguinal nodes are positive.

Wound Closure

Sartorius muscle transposed over femoral vessels; drain placed; wound closed.

Outcomes

120–180 minDURATION

3–5 DaysHOSPITAL STAY

>85% node-negativeSUCCESS RATE

4–6 WeeksFULL RECOVERY

Who Needs This Treatment?

→Curative for lymph node-confined penile cancer — 5-year survival exceeds 85% for N1 disease.
→Most important prognostic and therapeutic procedure in penile cancer management.
→Bilateral dissection treats both groins as cross-drainage is common.
→Sartorius transposition protects femoral vessels reducing vascular complication risk.
→Early surgery before nodal fixation gives best oncological outcomes.
→Pelvic dissection added for deeper nodal involvement extending coverage.

"Inguinal lymph node dissection is the most important operation we perform in penile cancer. Done thoroughly and early, it cures lymph node disease — and in penile cancer, that is where survival is determined."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

What are the complications of inguinal lymph node dissection?+

Is sentinel node biopsy an alternative to full dissection?+

What is the prognosis after node-positive dissection?+

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