What Is a Penectomy?

A penectomy is an operation to remove all or part of a penis. This type of surgery is usually done as part of the treatment for cancer of the penis. It is an effective cancer treatment, but it does significantly change your life.

Learn more about penectomies and what life is like after having one. 

What Is Penile Cancer?

Penile cancer is cancer that occurs anywhere on the penis. It’s a relatively rare condition, with only about 2,200 cases in the United States per year. Penile cancer can be treated, and surgery is the most common treatment. Sixty percent of people who have penile cancer will survive for five years after the original diagnosis.

Most cancers on the penis are skin cancer, but there are other types of penile cancer as well. The most common types of penile cancer include:‌

  • Squamous cell carcinoma. Squamous cell cancers can appear anywhere on the penis, but they are most often found on the foreskin.‌
  • Basal cell carcinoma. These are seldom found on the penis, but they can happen. They do not grow rapidly. ‌‌
  • Melanoma. Melanoma is the most dangerous type of skin cancer, as it grows quickly and spreads throughout the body. However, it usually begins on skin that is routinely exposed to the sun, so it is not common on the penis. ‌
  • Adenocarcinoma. These carcinomas are very similar to the ones on the skin, but they begin in the sweat glands of the penis. ‌
  • Sarcoma. In some cases, you may have a sarcoma of the penis. This type of cancer begins in the soft tissue such as blood vessels, muscle, or connective tissue. It can happen on any part of a penis.

Types of Penectomy

Surgery is the most effective treatment for any type of cancer on the penis. Doctors will operate to remove cancer and any tissue surrounding it to prevent it from spreading. The extent of the surgery depends on how deep inside the penis the cancer has gone. 

In many cases, the cancer is confined to the skin, so doctors can just remove the top layers of the skin. Depending on where on the penis the cancer is located, doctors might remove only the foreskin, the glans, or a section of skin further down on the penis. After these operations, most men have normal sexual and urinary function. 

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If cancer has moved into the tissue of the penis itself, doctors may need to remove all or part of the penis. This procedure is called a penectomy. There are three types of penectomies:

Partial Penectomy. Doctors will remove the head of the penis and any affected parts of the shaft. Doctors usually try to leave as much of the shaft in place as possible to ensure that the patient can still urinate standing up and some sexual function remains.

Total penectomy. If doctors can’t save the shaft of the penis, they will remove the whole organ. They will also remove the roots of the penis that extend up into the pelvic area. Doctors move the urethra to the space between the testicles and the anus. The patient will be able to control urination, though they will have to sit to urinate. Sexual intercourse is no longer possible. Sometimes, doctors can perform reconstructive surgery after a total penectomy. ‌

Emasculation. Very rarely, cancer spreads to such an extent that doctors have to remove the scrotum and testicles as well as the penis. Since the testicles produce most of the testosterone in the body, any man who has had this operation will need to be on hormone replacement therapy for the rest of his life. 

Life After a Penectomy

Penis removal is a drastic change to your life. Not only do you experience the fear and stress that comes with a cancer diagnosis, but the emotional impact of losing your penis is dramatic. Doctors and therapists will be able to help you manage your feelings about the changes to your body. 

‌You may need to change the way you urinate or sit to urinate after a penectomy. If you have enough penis remaining to stand for urination, you may need to adjust how you position yourself and learn new ways to keep your penis clean.‌

Many people can continue to enjoy pleasurable sexual activities after partial penectomy. They can still have erections when they are aroused. If the testicles are still present, they can have orgasms as well. 

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You cannot have sexual intercourse after total penectomy. However, if the scrotum and testicles are still present, you may be able to learn to orgasm from other kinds of stimulation. Being open with a trusted partner is an essential step in learning how to have sex after a penectomy.

If you need a penectomy, talk to your doctor about what to expect from the experience. 

WebMD Medical Reference Reviewed by Dan Brennan, MD on April 22, 2021

Sources

SOURCES: 

‌American Cancer Society: “About Penile Cancer.”

American Cancer Society: “Long-Term Side Effects of Penile Cancer Treatment.”

American Cancer Society: “Surgery for Penile Cancer.”

‌American Cancer Society: “What Is Penile Cancer?”

Cancer Research UK: “Sex and relationships with penile cancer.”

Nature: “Sexual Function after Partial Penectomy: A Prospectively Study From China.”

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