✦ Penile Cancer Treatment

Total Penectomy + Perineal Urethrostomy

Q: How do I urinate after total penectomy?

Urine passes through the perineal urethrostomy — a small opening in the perineum; patients sit to void and adapt quickly.

Q: Are testes preserved after total penectomy?

Testes and scrotum are preserved when not involved by tumour, maintaining testosterone production and avoiding androgen deficiency. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Q: What psychological support is available?

Specialist nurse counselling, psychological support services, and penile cancer patient support groups are available and strongly encouraged. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Complete Penile Removal with Perineal Urethrostomy for Advanced Penile Cancer

90–150 min PROCEDURE

3–5 Days HOSPITAL STAY

>75% SUCCESS RATE

4–6 Weeks RECOVERY

What is Total Penectomy + Perineal Urethrostomy?

Total Penectomy removes the entire penis at its base for advanced penile cancer not amenable to partial resection with clear margins, proximal corpora cavernosal involvement, or recurrence after partial penectomy. A perineal urethrostomy is simultaneously constructed, creating a permanent urethral opening in the perineum for voiding in the sitting position. Scrotum and testes are preserved when not involved by tumour. The procedure is performed under general or spinal anaesthesia with a hospital stay of 3–5 Days. Success rates reach >75% in appropriately selected patients at experienced centres.

Patients with advanced penile cancer (T3–T4) involving the proximal shaft or base, recurrent tumour after partial penectomy, or extensive bulky disease not amenable to partial excision. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Incision & Penile Degloving

Perineal and penile skin incisions; penile degloving from base.

Corpora Division

Corpora cavernosa divided at the pubic arch; urethra divided distally.

Specimen Removal

Penile specimen removed; haemostasis secured.

Perineal Urethrostomy

Perineal urethrostomy created by spatulating the urethra and suturing to perineal skin.

Wound Closure & Lymph Node Planning

Wound closed; urethral catheter left for 5–7 days; bilateral inguinal node dissection planned for staging.

Outcomes

90–150 minDURATION

3–5 DaysHOSPITAL STAY

>75%SUCCESS RATE

4–6 WeeksFULL RECOVERY

Who Needs This Treatment?

→Achieves clear surgical margins for advanced proximal penile tumours.
→Perineal urethrostomy provides reliable voiding in seated position.
→Scrotum and testes preserved maintaining testosterone production.
→Best oncological margins for tumours extending to the base of the penis.
→Definitive treatment preventing local progression and urethral obstruction.
→Combined with bilateral inguinal node dissection for complete oncological control.

"Total penectomy is a profound operation, but when it is the right operation, it is lifesaving. Our focus is on delivering a complete oncological clearance while maintaining the best possible quality of life with comprehensive support."

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

Common Questions

Frequently Asked

How do I urinate after total penectomy?+

Are testes preserved after total penectomy?+

What psychological support is available?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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