Operative note 32 Advanced
Penile cancer surgery
What it does: remove penile tumour, keep function where safe.
partial penectomy
- Leave 3-4 cm minimum. He voids standing.
- Glove sewn over the tumour.
- Tourniquet at the base, penis emptied first.
- Mark the margin: a clear margin of a few mm is oncologically safe (EAU); the old 2 cm rule is historical.
- Skin cut. Dorsal bundle tied.
- Corpora cut, top to bottom.
- Cavernosal arteries tied, 3/0.
- Urethra cut 1 cm BEYOND the corporal cut. Spatulate it.
- Corpora closed with transverse 2/0.
- Skin closed upright. Full-thickness urethra to skin. Catheter 10 days.
total penectomy + perineal urethrostomy
- Circle cut at the base, plus 2 cm up and down.
- Suspensory ligament cut. Vessels clipped.
- Urethra freed at mid-shaft, right angle behind it.
- Corpora divided at the pubic rami. Oversewn.
- Urethra tunnelled under skin to a perineal hole.
- Spatulate. Stitch full thickness. Close sideways.
- 2026 update: Sentinel node biopsy in the groin is now standard in UK centres. Not routine full groin clearance.
- 2026 update: Laser, brachytherapy, glans resurfacing: penis-sparing options for low risk.
From the UroRef Operative Quick Guide.