Glansectomy with split-thickness skin graft for the treatment of penile carcinoma

Abstract

Using our prospectively derived database, we identified 17 patients with squamous-cell carcinoma involving the glans penis, who were treated using organ-sparing surgery between March 2003 and January 2008. Of them, two were treated with partial glansectomy with primary glans closure, and 15 underwent total glans amputation and reconstruction of a new glans using a split-thickness skin graft (STSG). These 15 patients represent the subject of our study (mean age 51 years, range 42 to 59 years). Overall, two patients had early partial loss of the graft and of them, one required surgical regrafting. Two late complications occurred, consisting of one meatal stenosis and one postoperative phimosis. At a mean follow-up of 36 months, functional results were extremely satisfactory. All patients maintained their erectile function with good vaginal penetration starting from 3 months after surgery, with a range between 2 and 6 months. Orgasm and ejaculation were preserved in all patients, although reduced glans sensitivity was reported by all patients. No local recurrences were reported.

Surgical treatment of primary disease for penile squamous cell carcinoma: A Surveillance, Epidemiology, and End Results database analysis

“…The five-year cancer-specific survival rate following local recurrence was 92% in two large studies (1,6). In addition, sexual function, micturition and cosmetic results were generally well maintained following conservative surgery (3,(6)(7)(8)(20)(21)(22)(23). Accordingly, the use of PSS has risen dramatically at tertiary care centers and has been recommended by certain guidelines, including the European Association of Urology (EAU) Guidelines Group on Penile Cancer, as a standard surgical approach (11-13).…”

An update on penile reconstruction

“…5 Overall, almost all patients retain sexual and urinary function and are reported to be already engaging in satisfactory penetrative sex 3 months postoperatively. 6 Alternatively, glans and coronal reconstruction can be also achieved with the use of urethral, rectus abdominis or palmaris longus flaps. 7,8 Although the results are satisfactory, only few cases reports have been described in the literature and therefore, larger series will be necessary to confirm the reliability of these techniques for glans reconstruction.…”

“…5,6 Regardless of the cause of glans amputation, reconstruction can be achieved with a STSG that is applied on the corporal heads to form a pseudoglans ( Figure 2). …”

Organ-sparing reconstructive surgery in penile cancer: initial experiences at two Swedish referral centres

“…However, during the past two decades various less-mutilating techniques have been described and proposed for organ-preserving and reconstructive surgery in the treatment of penile cancer. The development of these techniques has reduced the negative impact on the functional and cosmetic outcomes associated with penectomy without jeopardizing long-term local oncological control [2][3][4][5][6][7][8].…”