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denuded glans penis is then covered with an extra-genital skin graft. Ten patients underwent TGR: six had recurrent erythroplasia of Queyrat after 5% 5-fluorouracil (5-FU) therapy; one had no clinical response to 5-FU or imiquimod; one had a severe allergic reaction and therefore could not tolerate 5-FU; and two had extensive glans hyperkeratosis and severe dysplasia. RESULTSThere were no postoperative complications. All skin grafts took successfully, and the cosmetic results were excellent. In all cases, pathological resection margins were clear. To date, there has been no evidence of disease recurrence on follow-up (median 30 months, range 7-45).

requiring surgery were offered either a glanspreserving or a glans-removing procedure. RESULTSOf the 78 patients referred, 49 required surgery, with penile-preserving procedures in 39 of them; 32 were newly diagnosed tumours and seven were recurrences after radiotherapy. The tumour grade and stage were G1 in 11, G2 in 17 and G3 in 10 (one had melanoma and was not graded); and Ta in two, T1 in 19, T2 in 17 and T3 in one. The mean follow-up was 16 months, with nine patients followed for ≥ 2 years. Complications included two patients who required immediate revisional surgery for positive resection margins, and one with radio-necrosis. One patient who had a glans-preserving procedure developed a recurrence, whereas none of those who had the glans removed did so. CONCLUSIONWith careful patient selection and meticulous follow-up, most patients with invasive penile carcinoma can be offered penile-preserving surgery.

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