Type of Surgery

Penectomy Surgery Information

Doctor Certified

Last updated: 02/05/2010

A penectomy is a surgery to remove part or the entire penis. The partial penectomy definition includes the removal of any part of the penis less than total. Strictly speaking, circumcision is a partial penectomy focusing on removing the foreskin of the penis; however a circumcision is rarely defined as a penectomy or even partial penectomy.

Penectomy surgery is most often performed to treat cancer. Cancers of the penis usually require that a portion of the penis be removed through partial penectomy. This surgical approach would also be used to treat cancers of the urethra (the tube through which urine is passed). In the case of urethral cancer, though, often a total penectomy (total removal of the penis) is required.

A penectomy procedure may be performed in situations where the penis is infected or contains an abscess. In order to consider penectomy surgery for an abscess or infection, medical treatment with antibiotics and less extensive surgical procedures like incision and drainage are usually tried and have failed. A penectomy would be performed in this context if significant tissue damage has occurred or the spread of infection is particularly worrisome (as it would be in the immunocompromised).

Penectomy surgery is part of a male to female, transgender, sex reassignment surgery. Depending on the surgical approach of the sex reassignment, the penectomy may be combined with a revision of the penile tissue to form part of the female sex organs. Nerve endings in the penis are densely packed making it a sensitive region of skin. When possible, skin and underlying tissue of the penis is salvaged after the penectomy to form a man-made clitoris and/or vagina.

When penectomy surgery is being performed to treat cancer or abscess or a permanent lack of blood flow (with necrosis and tissue death), as much of the penis as possible is spared. The goal of a penectomy procedure, like other cancer surgery, is to remove all traces of cancer but to leave as much functional tissue as possible. The penis performs important urinary and sexual functions that should be preserved after penectomy, if possible.

A penectomy is a major surgical procedure requiring general anesthesia. Rarely is the procedure combined with lymph node sampling and other procedures that determine the extent and severity of a tumor. These procedures may be done weeks after the initial penectomy surgery.

Obviously there will be a period of adjustment after a penectomy.  A penectomy procedure can be emotionally and physically trying. Loved ones (especially sexual partners) and the patient himself should be counseled before and after the procedure. In the case of sex reassignment surgery, a thorough psychiatric evaluation is usually required beforehand. The patient should seek out urologists, psychiatrists and psychologists that have experience dealing with the issues associated with penectomy surgery.

 

In some cases, a penectomy can be combined with a phalloplasty procedure. Either an artificial penis or penis constructed from a person's own skin and tissues is constructed in place of the removed phallus. This procedure may or may not be performed at the time of the penectomy. Patients should have a frank discussion about penile implants, penis reconstruction, and other phalloplasty techniques before the penectomy is performed. At that time, the timing of additional procedures should be discussed.


Last Updated: 02/05/2010

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