Abstract:Introduction: The objective of this work is to describe a conservative surgical technique as an alternative to classic penile amputations, aiming the local control of the disease, in addition to trying to preserve the patient's sexual function.Surgical technique: After a circular incision of the skin around the penis, the subfascial plane is developed until the base of the organ. The dorsal neurovascular bundle and the urethra are isolated in their distal extremities. The neurovascular bundle is sectioned dist… Show more
“…Moreover, pre-cancerous lesions often show recalcitrance after conservative treatments, with final development of SCC in 5–33% of cases [4,9,11–13] . Recently, plastic and reconstructive surgical techniques have been developed to reduce the functional and psychological morbidity in patients who have undergone mutilating penile surgery [1–3,9,14–17] . In selected patients, the use of these relatively new plastic approaches with total glans reconstruction provided a satisfactory aesthetic and functional outcome, without sacrificing rigorous cancer control [1–3] .…”
PurposeTo describe the technique and results of penis-sparing surgery combined with a cosmetic neo-glans reconstruction for benign, pre-malignant or malignant penile lesions.Patients and methodsTwenty-one patients (mean age 61 years) with penile lesions with a broad spectrum of histopathology underwent organ-sparing surgery with neo-glans reconstruction, using a free split-thickness skin graft harvested from the thigh. Three patients were treated by glans-skinning and glans-resurfacing, 10 by glansectomy and neo-glans reconstruction, four by partial penectomy and a neo-glans reconstruction, and four by neo-glans reconstruction after a traditional partial penectomy.ResultsThe mean follow-up was 45 months; all patients were free of primary local disease. All patients were satisfied with the appearance of the penis after surgery, and recovered their sexual ability, although sensitivity was reduced as a consequence of glans/penile amputation.ConclusionIn benign, premalignant or malignant penile lesions, penis-sparing surgery combined with a cosmetic neo-glans reconstruction can be used to assure a normally appearing and functional penis, while fully eradicating the primary local disease.
“…Moreover, pre-cancerous lesions often show recalcitrance after conservative treatments, with final development of SCC in 5–33% of cases [4,9,11–13] . Recently, plastic and reconstructive surgical techniques have been developed to reduce the functional and psychological morbidity in patients who have undergone mutilating penile surgery [1–3,9,14–17] . In selected patients, the use of these relatively new plastic approaches with total glans reconstruction provided a satisfactory aesthetic and functional outcome, without sacrificing rigorous cancer control [1–3] .…”
PurposeTo describe the technique and results of penis-sparing surgery combined with a cosmetic neo-glans reconstruction for benign, pre-malignant or malignant penile lesions.Patients and methodsTwenty-one patients (mean age 61 years) with penile lesions with a broad spectrum of histopathology underwent organ-sparing surgery with neo-glans reconstruction, using a free split-thickness skin graft harvested from the thigh. Three patients were treated by glans-skinning and glans-resurfacing, 10 by glansectomy and neo-glans reconstruction, four by partial penectomy and a neo-glans reconstruction, and four by neo-glans reconstruction after a traditional partial penectomy.ResultsThe mean follow-up was 45 months; all patients were free of primary local disease. All patients were satisfied with the appearance of the penis after surgery, and recovered their sexual ability, although sensitivity was reduced as a consequence of glans/penile amputation.ConclusionIn benign, premalignant or malignant penile lesions, penis-sparing surgery combined with a cosmetic neo-glans reconstruction can be used to assure a normally appearing and functional penis, while fully eradicating the primary local disease.
“…Moreover, precancerous lesions often show recalcitrance after conservative treatments, with final evolution to a SCC in 5 to 33% of the cases [4,9,[15][16][17]. Recently, plastic and reconstructive surgical techniques have been developed to reduce the functional and psychological morbidity in patients who have undergone mutilating penile surgery [1][2][3]9,[11][12][13][14]. In selected patients, the use of these relatively-new plastic and reconstructive approaches provided a satisfactory aesthetic and functional outcome, without sacrificing a rigorous cancer control [1][2][3].…”
“…With extended follow-up, the results have been promising (39). Glansectomy has been reported with no local recurrences in select cases (38,40,41). Others have performed partial glansectomy and partial penectomy with reconstruction of the glans (38,41,42).…”
Purpose: The management of penile cancer has evolved as less invasive techniques are applied in the treatment of the primary tumor and inguinal lymph nodes. Materials and Methods: Herein we review the literature focusing on advances in the preservation of the phallus as well as less morbid procedures to evaluate and treat the groins. Results: Promising imaging modalities for staging are discussed. New techniques are described and tables provided for penile preservation. We also review the contemporary morbidity of modified surgical forms for evaluation of the inguinal nodes. Conclusions: Advances in surgical technique have made phallic preservation possible in a greater number of primary penile cancers. The groins can be evaluated for metastasis with greater accuracy through new radiologic means as well as with less morbid modified surgical techniques.
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