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Role of a glansectomy in treatment of penile cancer


Authors: Milan Hora 1;  Karel Pizinger 2;  Vlastimil Bursa 3;  Michal Sviták 3;  Petr Stránský 1;  Viktor Eret 1;  Ondřej Hes 4;  Denisa Kacerovská 4;  Dmitry Kazakov 4;  Jiří Ferda 5;  Boris Kreuzberg 5
Authors‘ workplace: Urologická klinika LF UK a FN, Plzeň 1;  Dermatovenerologická klinika LF UK a FN, Plzeň 2;  Oddělení plastické chirurgie LF UK a FN, Plzeň 3;  Šiklův patologicko-anatomický ústav LF UK a FN, Plzeň 4;  Klinika zobrazovacích metod LF UK a FN, Plzeň 5
Published in: Ces Urol 2011; 15(1): 15-23
Category: Original article

Overview

Aim:
Some lower categories of penile cancer are unnecessarily treated with a mutilated partial amputation of the penis. We present a more suitable alternative – a glansectomy.

Material and methods:
From 8/2006 to 8/2010, 28 men with penile tumours were surgically treated at the University Hospital Plzeň, CZ. Seven underwent a partial amputation, two total amputation, 7 circumcision, three an excision of the lesion (including one partial glansectomy). Nine (32%) underwent glansectomy. These cases are retrospectively evaluated, but the data was collected prospectively.

Results:
The mean age was 69.0 ± 8.1 years (59.0–80.9). The tumour was verified histologically preoperatively in 5 cases, once preoperatively and 3 tumours were indicated only by macroscopically viewing them with the consideration of a possible future variant of treatment. A definitive histology of squamous carcinoma (2 times its verrucous variant) was in all cases, pT category 2× CIS, 6× pT1 (one from preoperative biopsy, definitive histology was CIS only) and 1× pT2. Grading was 6× 1 (including 3 CIS), 3× 2. Three times there was corpora cavernosa covered with a skin graft, 6× with the skin of the shaft of the penis only (in men without interest in sexual activity). In one case of a skin graft, the abscess of the wound was treated. The mean follow-up was 28 months without local recurrence. Once glansectomy was combined with bilateral inguinal lymphadenectomy, this patient had a recurrence 9 months later in the left groin.

Conclusion:
Glansectomy affords better cosmetic and psychological effect in comparison with partial amputation, preserving the maximal length of the penis, sex life and micturition. And good oncological results are saved. Covering of the corpora cavernosa with a skin graft is more aesthetic, but surgery and postoperative care is more complicated than only using the skin of the shaft of the penis.

Key words:
penile tumours, glansectomy, split-thickness, sexual dysfunction.


Sources

1. Austoni E, Fenice O, Kartalas Goumas Y, et al. New trends in the surgical treatment of penile carcinoma. Arch Ital Urol Androl 1996; 68: 163–168.

2. Davis JW, Schellhammer PF, Schlossberg SM. Conservative surgical therapy for penile and urethral carcinoma. Urology 1999; 53: 386–392.

3. Hatzichristou DG, Apostolidis A, Tzortzis V, et al. Glansectomy: an alternative surgical treatment for Buschke-Lowenstein tumours of the penis. Urology 2000; 57: 966–969.

4. Pietrzak P, Corbishley C, Watkin N. Organ-sparing surgery for invasive penile cancer: early follow-up data. BJU Int 2004; 94(9): 1253–1257.

5. Smith Y, Hadway P, Biedrzycki O, et al. Reconstructive surgery for invasive squamous carcinoma of the glans penis. Eur Urol 2007; 52(4): 1179–1185.

6. Venkov G, Laaser MK. Reconstruction of tissue defects on the glans penis by transplantation of buccal mucosa. Aktuelle Urol 2008; 39(3): 219–224.

7. De Fonseca AG, Rabelo GN, Vidal KSM, De Sousa FJ. Glandectomy with preservativ of corpora cavernosa in th treatment of penile carcinoma. Int Braz J Urol 2003; 29(5): 437–440.

8. Morelli G, Pagni R, Mariani C, et al. Glansectomy with split-thickness skin graft for the treatment of penile carcinoma. Int J Impot Res 2009; 21(5): 311–314.

9. Minhas S, Kayes O, Hegarty P, et al. What surgical resection margins are required to achieve oncological control in men with primary penile cancer? BJU Int 2005; 96(7): 1040–1043.

10. Gulino G, Sasso F, Falabella R, Bassi PF. Distal urethral reconstruction of the glans for penile carcinoma: results of a novel technique at 1-year of followup. J Urol 2007; 178(3 Pt 1): 941–944.

11. Palminteri E, Berdondini E, Lazzeri M, et al. Resurfacing and reconstruction of the glans penis. Eur Urol 2007; 52(3): 893–898.

12. Schlenker B, Gratzke C, Tilki D, et al. Organ-sparing surgery for penile cancer. Urologe A 2008; 47(7): 803–804, 806–808.

13. Smith Y, Hadway P, Ahmed S, et al. Penile-preserving surgery for male distal urethral carcinoma. BJU Int 2007; 100(1): 82–87.

14. Hora M, Ürge T, Eret V, et al. Glansektomie. Čes Urol 2009; 13(4): 281.

15. Hora M, Stránský P, Ferda J, et al. Využití PET/CT v diagnostice uzlinového postižení u karcinomu penisu. Čes Urol 2009; 13(4): 282.

16. Bracka A. Glans resection and plastic repair. BJU Int 2009; 105: 136–144.

17. Hegarty PH, Shabbir M, Hughes B, et al. Penile preserving surgery and surgical strategies of maximize penile form and function in penile cancer: recommendations from the United Kingdom experience. World J Urol 2009; 27(2): 179–187.

18. Sharp DS, Angermeiere KW. Surgery of penile and ureteral carcinoma, Conservative surgical excision. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh Urology, 9th edition. Philadelphia, PA: Saunders Elsevier 2007; 994–996.

19. Novotvary 2007 ČR. Praha: ÚZIS 262.

20. Hanuš T, Kočvara R. Koncepce urologie. Praha: ČUS 2007. http://www.cus.cz/page.php?name=koncepce-oboru-urologie

21. Novák J, Žídek I. Carcinoma of the penis. Praha: Grada Publishing 1996: 93.

22. Novák J, Bárta J, Klézl P. Karcinom penisu. Čas Lék čes 2007; 146(10): 767–770.

23. Čermák A, Pacík D. Terapie nádorů penisu. In: Dvořáček J, Babjuk M. et al. Onkourologie. Praha: Galén a Karolinum 2005: 453–461.

24. Pizzocaro G, Algaba F, Horenblas S, et al. EAU Penile Cancer Guidelines 2009. Eur Urol 2010; 57(6): 1002–1012.

25. Hatzichristou DG, Tzortzis V, Hatzimouratidis K, et al. Protective role of the glans penis during coitus. Int J Impot Res 2003; 15(5): 337–342.

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Paediatric urologist Nephrology Urology
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