Total Penectomy
In some cases, the best way to treat penile cancer is with a total penectomy. This is not an easy treatment physically or emotionally. This page explains why it might be recommended and details the surgery involved.
A total penectomy is an operation to remove the whole of the penis and is only recommended if it is absolutely necessary.
It will be performed under a general anaesthetic and the operation is likely to take several hours to complete.
After the operation, men will be given painkillers on a regular basis. It is important that you take these regularly and not just when pain is felt.
The site of the operation will have a wound dressing over it which will also cover the scrotum. This will usually be removed after two to three days. Doctors and nurses will check the dressings and the wound site regularly.
For the first 24 hours, or perhaps longer, men are likely to have a small plastic tube called a wound drain in place. This is to remove excess blood or fluid which can sometimes gather at the operation site. This will allow unwanted substances to drain naturally and healing to take place.
Men will have a urinary catheter (urine drainage tube) which will usually need to remain in place for up to 14 days.
Men will need to take things easy for four to six weeks after surgery and avoid any strenuous activity such as heavy lifting, shopping or gardening while the wound heals. They may need to wear anti-embolism stockings (anti blood clot stockings) to protect the circulation in the legs during, and for some time after the operation. They may also be given blood thinning medication.
Stitches will be dissolvable but may take four to six weeks to fully disperse.
An appointment will usually be made after a few weeks to check that the operation site is healing. At this appointment, the medical team will also discuss the results of the operation and whether any further treatment is needed.
About Urination
After the operation, once the urinary catheter is removed men will be able to urinate independently as the sensation and need to pass urine will not be affected. The urethra will be surgically reshaped to form a special urinary drainage passage called a perineal urethrostomy. After surgery, in future men will need to sit down on a toilet to pass urine.
Post Operative Concerns
Men should contact the healthcare team if ythey experience any of the following:
- Persistent bleeding from the wound.
- Uncontrolled pain.
- A high temperature and shaking or feeling as if you have a bad cold – this could be a sign of infection.
- Prolonged swelling, redness or a foul-smelling discharge from around the wound site which could mean a localised infection.
- Difficulty in passing urine.
Urination
Following total penectomy men will have to sit down at the toilet to pass urine. It is possible to purchase a special key (RADAR Key) which allows anyone who need to urinate more frequently to access otherwise locked or non public toilet facilities. These can be purchased from Disability Rights
A toilet card can also be obtained which may allow access otherwise private amenities such as toilets in shops. Further information can be found here.